{"text_format":"1","workbook":"xlsx","n_sheets":17,"sheets":["Cover Page","Page 1 ","Pg 2 Gp Sz Determination Form","Page 3 - Plan Info","Plan Info Lookups","Page 4 - Rates Insured","Page 4 - Rates Insured (2)","Page 4 -Rates Insured Voluntary","Page 4 - Rates ASO","Page 4 - Rates Minimum Premium","Page 5 - Agent-Signature pg","Page 7 - ESA Agreement ","Nondiscrimination_Taglines","Page 8 - Acct Structure","RX_ELIGIBILITY_LG_DROPDOWN (2)","Checklist","Pg 13-Consortium Fees(Internal)"],"not_rendered":{"charts":0,"images":7,"macros":1,"external_links":3,"defined_names":62,"comments":10,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Cover Page","index":0,"n_rows":35,"n_cols":10,"rows_kept":35,"cut":false,"hidden":false,"merged":[[11,0,11,9],[12,0,12,9],[20,1,20,9],[34,0,34,9],[4,0,4,9],[5,0,5,9],[7,0,7,9],[8,0,8,9],[9,0,9,9],[10,0,10,9]]}
[]
[]
[]
[]
["Hello."]
["Thank you for choosing Moda Health and Delta Dental."]
[]
["Please forward the completed copy to:"]
["ModaGroupSales@modahealth.com"]
["or"]
["Print and mail a completed copy to:"]
["Moda Health and Delta Dental\nAttn: Sales and Account Services 10th Floor"]
["601 SW Second Avenue Portland, OR 97204"]
[]
[]
["New Group Enrollment Checklist for Employers and Agents"]
["Please note, if any of the below items are not completed in full, enrollment will be delayed."]
[]
[null,"Group Application - Completed and Signed by Group and Agent"]
[null,"Enrollment Forms for All Eligible Employees (include hire dates on all enrollment forms)"]
[null,"Declinations for all employees waiving or opting out (applicable to groups with all levels of participation)"]
[null,"First Month's Premium (make check payable to Moda Health)"]
[null,"EOS Agreement/ EFT (electronic funds transfer) Authorization Form - if applicable"]
[null,"Late Acknowledgement Agreement (If enrolling past the 10th of the month)"]
[]
[]
["Member Handbooks"]
["We encourage our members to view their handbooks from their myModa account at",null,null,null,null,null,null,null,null,"www.modahealth.com/mymoda"]
[]
[]
[]
[]
[]
[]
["All new group enrollment materials must be received by Moda Health and Delta Dental no later than the 10th of the month for a first of the following month's effective date."]

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[null,null,null,null,null,null,null,"Oregon Large Employer Group Application (51+)",null,null,null,null,null,null,null,null,null,null,null,null,null,30,2,null,{"$f":"D5","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,60,3]
[null,null,"EFFECTIVE DATE:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,90,4]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,120,5]
[null,null,"TYPE:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,150,6]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,180,7]
["GROUP INFORMATION:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,210,8]
["Legal Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,240,9]
["Billing Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,270,10]
[]
[]
[null,null,"Street Address:",null,null,null,null,null,null,null,"City/State/Zip:",null,null,null,null,null,null,null,null,null,30,60,90,120,150,180,210,240,270]
[null,null,"Billing Address:",null,null,null,null,null,null,null,"City/State/Zip:",null,null,null,null,null,null,null,null,"2014-01-01","2013-12-01","2013-11-01","2013-10-01","2013-09-01","2013-08-01","2013-07-01","2013-06-01","2013-05-01","2013-04-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014-02-01","2014-01-01","2013-12-01","2013-11-01","2013-10-01","2013-09-01","2013-08-01","2013-07-01","2013-06-01","2013-05-01"]
[null,null,"Group Administrator:",null,null,null,null,null,null,null,"Billing Contact:",null,null,null,null,null,null,null,null,"2014-03-01","2014-02-01","2014-01-01","2013-12-01","2013-11-01","2013-10-01","2013-09-01","2013-08-01","2013-07-01","2013-06-01"]
[null,null,"Phone #:",null,null,null,null,null,null,null,"Phone #:",null,null,null,null,null,null,null,null,"2014-04-01","2014-03-01","2014-02-01","2014-01-01","2013-12-01","2013-11-01","2013-10-01","2013-09-01","2013-08-01","2013-07-01"]
[null,null,"Fax #:",null,null,null,null,null,null,null,"Fax #:",null,null,null,null,null,null,null,null,"2014-05-01","2014-04-01","2014-03-01","2014-02-01","2014-01-01","2013-12-01","2013-11-01","2013-10-01","2013-09-01","2013-08-01"]
[null,null,"E-mail Address:",null,null,null,null,null,null,null,"E-mail Address:",null,null,null,null,null,null,null,null,"2014-06-01","2014-05-01","2014-04-01","2014-03-01","2014-02-01","2014-01-01","2013-12-01","2013-11-01","2013-10-01","2013-09-01"]
[null,null,"Tax ID #:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014-07-01","2014-06-01","2014-05-01","2014-04-01","2014-03-01","2014-02-01","2014-01-01","2013-12-01","2013-11-01","2013-10-01"]
[null,null,"Renewal Date:",null,null,null,null,null,null,null,"Advance Renewal Notice (days):",null,null,null,null,null,null,null,null,"2014-08-01","2014-07-01","2014-06-01","2014-05-01","2014-04-01","2014-03-01","2014-02-01","2014-01-01","2013-12-01","2013-11-01"]
[null,null,"Notification Month/Year:",{"$f":"IF(D20=\"\",\"\",IF(L20=\"\",\"\",((DATE(YEAR(D20),MONTH(D20),DAY(D20))-L20))))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014-09-01","2014-08-01","2014-07-01","2014-06-01","2014-05-01","2014-04-01","2014-03-01","2014-02-01","2014-01-01","2013-12-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014-10-01","2014-09-01","2014-08-01","2014-07-01","2014-06-01","2014-05-01","2014-04-01","2014-03-01","2014-02-01","2014-01-01"]
["ELIGIBILITY:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014-11-01","2014-10-01","2014-09-01","2014-08-01","2014-07-01","2014-06-01","2014-05-01","2014-04-01","2014-03-01","2014-02-01"]
["1.","What percentage of the medical premium is to be contributed by the employer?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014-12-01","2014-11-01","2014-10-01","2014-09-01","2014-08-01","2014-07-01","2014-06-01","2014-05-01","2014-04-01","2014-03-01"]
[null,null,null,null,null,null,null,null,null,"For employees:",null,null,"For dependents:",null,null,null,null,null,null,"2015-01-01","2014-12-01","2014-11-01","2014-10-01","2014-09-01","2014-08-01","2014-07-01","2014-06-01","2014-05-01","2014-04-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2015-02-01","2015-01-01","2014-12-01","2014-11-01","2014-10-01","2014-09-01","2014-08-01","2014-07-01","2014-06-01","2014-05-01"]
["2.","What percentage of the dental premium is to be contributed by the employer?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2015-03-01","2015-02-01","2015-01-01","2014-12-01","2014-11-01","2014-10-01","2014-09-01","2014-08-01","2014-07-01","2014-06-01"]
[null,null,null,null,null,null,null,null,null,"For employees (minimum 50%):",null,null,"For dependents:",null,null,null,null,null,null,"2015-04-01","2015-04-01","2015-03-01","2015-02-01","2015-01-01","2014-12-01","2014-10-01","2014-09-01","2014-08-01","2014-07-01"]
["3.","Will the plan be integrated or standalone – specifically – Integrated is when all plans are purchased/bundled together and an employee and their family cannot waive. ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2015-05-01","2015-05-01","2015-04-01","2015-03-01","2015-02-01","2015-01-01","2014-11-01","2014-10-01","2014-09-01","2014-08-01"]
["3a.","For the dental plan – is this integrated with the medical plan? Y/N (regardless if Moda is the medical carrier)",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2015-06-01","2015-06-01","2015-05-01","2015-04-01","2015-03-01","2015-02-01","2014-12-01","2014-11-01","2014-10-01","2014-09-01"]
["3b.","For the vision plan – is the vision plan integrated with the medical plan? Y/N (regardless if Moda is the medical carrier)",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2015-07-01","2015-07-01","2015-06-01","2015-05-01","2015-04-01","2015-03-01","2015-01-01","2014-12-01","2014-11-01","2014-10-01"]
[null,null,null,null,null,null,"(Yes = Integrated; No = Standalone )",null,null,null,null,null,null,null,null,null,null,null,null,"2015-08-01","2015-08-01","2015-07-01","2015-06-01","2015-05-01","2015-04-01","2015-02-01","2015-01-01","2014-12-01","2014-11-01"]
["4.","How many hours per week must an employee work to be eligible for benefits? ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2015-09-01","2015-09-01","2015-08-01","2015-07-01","2015-06-01","2015-05-01","2015-03-01","2015-02-01","2015-01-01","2014-12-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"(minimum 17.5  per week):",null,null,null,null,null,"2015-10-01","2015-10-01","2015-09-01","2015-08-01","2015-07-01","2015-06-01","2015-04-01","2015-03-01","2015-02-01","2015-01-01"]
["5.","Dependent age maximum:",null,null,{"$f":"IF(D5=\"NEW\",\"26\",\"\")","v":""},null,null,null,null,"Student age maximum:",{"$f":"IF(D5=\"NEW\",\"26\",\"\")","v":""},null,"Verified by:",null,null,null,null,null,null,"2015-11-01","2015-11-01","2015-10-01","2015-09-01","2015-08-01","2015-07-01","2015-05-01","2015-04-01","2015-03-01","2015-02-01"]
["6.","What is the eligibility period an employee must complete before becoming eligible for benefits?   ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2015-12-01","2015-12-01","2015-11-01","2015-10-01","2015-09-01","2015-08-01","2015-06-01","2015-05-01","2015-04-01","2015-03-01"]
[null,null,null,null,"The first of the month following:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2016-01-01","2016-01-01","2015-12-01","2015-11-01","2015-10-01","2015-09-01","2015-07-01","2015-06-01","2015-05-01","2015-04-01"]
[null,null,null,"Apply to all employees?","(Y/N):",null,null,null,null,"  If no, please describe the classification on page 4.",null,null,null,null,null,null,null,null,null,"2016-02-01","2016-02-01","2016-01-01","2015-12-01","2015-11-01","2015-10-01","2015-08-01","2015-07-01","2015-06-01","2015-05-01"]
["6a.","For the question above, specific to part time employees; does the time employed count towards the eligibility",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2016-03-01","2016-03-01","2016-02-01","2016-01-01","2015-12-01","2015-11-01","2015-09-01","2015-08-01","2015-07-01","2015-06-01"]
[null,"period for full time employees? (see below for additional clarification)",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2016-04-01","2016-04-01","2016-03-01","2016-02-01","2016-01-01","2015-12-01","2015-10-01","2015-09-01","2015-08-01","2015-07-01"]
[null,"Medical and Medical/Dental groups: This option is only available when the group's employee eligibility period is first of the month following 30 or 60 days.\nDental only groups: This option is only available when the group's employee eligibility period is first of the month following 30, 60 or 90 days. ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2016-05-01","2016-05-01","2016-04-01","2016-03-01","2016-02-01","2016-01-01","2015-11-01","2015-10-01","2015-09-01","2015-08-01"]
["7.","When do changes made during open enrollment become effective?",null,null,null,null,null,null,null,null,"At renewal?",null,"or date:",null,null,null,null,null,null,"2016-06-01","2016-06-01","2016-05-01","2016-04-01","2016-03-01","2016-02-01","2015-12-01","2015-11-01","2015-10-01","2015-09-01"]
["8.","Is the group subject to ERISA (Employee Retirement Income Security Act of 1974)? ",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2016-07-01","2016-07-01","2016-06-01","2016-05-01","2016-04-01","2016-03-01","2016-01-01","2015-12-01","2015-11-01","2015-10-01"]
["9.","Moda Health/Delta Dental policies include same enrollment rights for domestic partners who are registered under the laws of any federal, state or local government, as married couples have.  Your group will automatically be set up with this, unless you are an ERISA ASO group.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2016-08-01","2016-08-01","2016-07-01","2016-06-01","2016-05-01","2016-04-01","2016-02-01","2016-01-01","2015-12-01","2015-11-01"]
["9a.","If you are an ERISA ASO group, do you choose to include:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2016-09-01","2016-09-01","2016-08-01","2016-07-01","2016-06-01","2016-05-01","2016-03-01","2016-02-01","2016-01-01","2015-12-01"]
[" ","Domestic partners who are registered under the laws of any federal, state or local government (including Oregon Family ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2016-10-01","2016-10-01","2016-09-01","2016-08-01","2016-07-01","2016-06-01","2016-04-01","2016-03-01","2016-02-01","2016-01-01"]
[null,"Fairness Act?)",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2016-11-01","2016-11-01","2016-10-01","2016-09-01","2016-08-01","2016-07-01","2016-05-01","2016-04-01","2016-03-01","2016-02-01"]
["9b.","The Oregon Family Fairness Act?  ",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2016-12-01","2016-12-01","2016-11-01","2016-10-01","2016-09-01","2016-08-01","2016-06-01","2016-05-01","2016-04-01","2016-03-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2017-01-01","2017-01-01","2016-12-01","2016-11-01","2016-10-01","2016-09-01","2016-07-01","2016-06-01","2016-05-01","2016-04-01"]
["9c.","For all groups, (insured or ASO, ERISA or non-ERISA):  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2017-02-01","2017-02-01","2017-01-01","2016-12-01","2016-11-01","2016-10-01","2016-08-01","2016-07-01","2016-06-01","2016-05-01"]
[null,"Is Domestic Partnership coverage available by affidavit?",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2017-03-01","2017-03-01","2017-02-01","2017-01-01","2016-12-01","2016-11-01","2016-09-01","2016-08-01","2016-07-01","2016-06-01"]
[null,"(This is separate from registered partners)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2017-04-01","2017-04-01","2017-03-01","2017-02-01","2017-01-01","2016-12-01","2016-10-01","2016-09-01","2016-08-01","2016-07-01"]
[null,null,null,null,null,null,null,null,null,null,"If yes, do you cover:",null,null,null,null,null,null,null,null,"2017-05-01","2017-05-01","2017-04-01","2017-03-01","2017-02-01","2017-01-01","2016-11-01","2016-10-01","2016-09-01","2016-08-01"]
["10.","Does the group have a bargaining agreement (Union) in force?",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2017-06-01","2017-06-01","2017-05-01","2017-04-01","2017-03-01","2017-02-01","2016-12-01","2016-11-01","2016-10-01","2016-09-01"]
[null,null,null,null,null,null,null,"If yes, effective date:",null,null,null,"Expiration date:",null,null,null,null,null,null,null,"2017-07-01","2017-07-01","2017-06-01","2017-05-01","2017-04-01","2017-03-01","2017-01-01","2016-12-01","2016-11-01","2016-10-01"]
["11.","Does the group represent or belong to an association or trust?   ",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2017-08-01","2017-08-01","2017-07-01","2017-06-01","2017-05-01","2017-04-01","2017-02-01","2017-01-01","2016-12-01","2016-11-01"]
[null,"If yes, provide the date filed with the State as a group policyholder and the approval number:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2017-09-01","2017-09-01","2017-08-01","2017-07-01","2017-06-01","2017-05-01","2017-03-01","2017-02-01","2017-01-01","2016-12-01"]
[null,null,null,null,null,null,null,null,"Date:",null,null,"Approval #:",null,null,null,null,null,null,null,"2017-10-01","2017-10-01","2017-09-01","2017-08-01","2017-07-01","2017-06-01","2017-04-01","2017-03-01","2017-02-01","2017-01-01"]
["12.","Will out of state employees (other than those in SW Washington) be covered by Moda Health?:",null,null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,"2017-11-01","2017-11-01","2017-10-01","2017-09-01","2017-08-01","2017-07-01","2017-05-01","2017-04-01","2017-03-01","2017-02-01"]
["If yes, list state (s) and number of employees in each:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2017-12-01","2017-12-01","2017-11-01","2017-10-01","2017-09-01","2017-08-01","2017-06-01","2017-05-01","2017-04-01","2017-03-01"]
["13.","What month does the group's fiscal year begin?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-01-01","2018-01-01","2017-12-01","2017-11-01","2017-10-01","2017-09-01","2017-07-01","2017-06-01","2017-05-01","2017-04-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-02-01","2018-02-01","2018-01-01","2017-12-01","2017-11-01","2017-10-01","2017-08-01","2017-07-01","2017-06-01","2017-05-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-03-01","2018-03-01","2018-02-01","2018-01-01","2017-12-01","2017-11-01","2017-09-01","2017-08-01","2017-07-01","2017-06-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-04-01","2018-04-01","2018-03-01","2018-02-01","2018-01-01","2017-12-01","2017-10-01","2017-09-01","2017-08-01","2017-07-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-05-01","2018-05-01","2018-04-01","2018-03-01","2018-02-01","2018-01-01","2017-11-01","2017-10-01","2017-09-01","2017-08-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-06-01","2018-06-01","2018-05-01","2018-04-01","2018-03-01","2018-02-01","2017-12-01","2017-11-01","2017-10-01","2017-09-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-07-01","2018-07-01","2018-06-01","2018-05-01","2018-04-01","2018-03-01","2018-01-01","2017-12-01","2017-11-01","2017-10-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-08-01","2018-08-01","2018-07-01","2018-06-01","2018-05-01","2018-04-01","2018-02-01","2018-01-01","2017-12-01","2017-11-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-09-01","2018-09-01","2018-08-01","2018-07-01","2018-06-01","2018-05-01","2018-03-01","2018-02-01","2018-01-01","2017-12-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-10-01","2018-10-01","2018-09-01","2018-08-01","2018-07-01","2018-06-01","2018-04-01","2018-03-01","2018-02-01","2018-01-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-11-01","2018-11-01","2018-10-01","2018-09-01","2018-08-01","2018-07-01","2018-05-01","2018-04-01","2018-03-01","2018-02-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2018-12-01","2018-12-01","2018-11-01","2018-10-01","2018-09-01","2018-08-01","2018-06-01","2018-05-01","2018-04-01","2018-03-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-01-01","2019-01-01","2018-12-01","2018-11-01","2018-10-01","2018-09-01","2018-07-01","2018-06-01","2018-05-01","2018-04-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-02-01","2019-02-01","2019-01-01","2018-12-01","2018-11-01","2018-10-01","2018-08-01","2018-07-01","2018-06-01","2018-05-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-03-01","2019-03-01","2019-02-01","2019-01-01","2018-12-01","2018-11-01","2018-09-01","2018-08-01","2018-07-01","2018-06-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-04-01","2019-04-01","2019-03-01","2019-02-01","2019-01-01","2018-12-01","2018-10-01","2018-09-01","2018-08-01","2018-07-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-05-01","2019-05-01","2019-04-01","2019-03-01","2019-02-01","2019-01-01","2018-11-01","2018-10-01","2018-09-01","2018-08-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-06-01","2019-06-01","2019-05-01","2019-04-01","2019-03-01","2019-02-01","2018-12-01","2018-11-01","2018-10-01","2018-09-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-07-01","2019-07-01","2019-06-01","2019-05-01","2019-04-01","2019-03-01","2019-01-01","2018-12-01","2018-11-01","2018-10-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-08-01","2019-08-01","2019-07-01","2019-06-01","2019-05-01","2019-04-01","2019-02-01","2019-01-01","2018-12-01","2018-11-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-09-01","2019-09-01","2019-08-01","2019-07-01","2019-06-01","2019-05-01","2019-03-01","2019-02-01","2019-01-01","2018-12-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-10-01","2019-10-01","2019-09-01","2019-08-01","2019-07-01","2019-06-01","2019-04-01","2019-03-01","2019-02-01","2019-01-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-11-01","2019-11-01","2019-10-01","2019-09-01","2019-08-01","2019-07-01","2019-05-01","2019-04-01","2019-03-01","2019-02-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2019-12-01","2019-12-01","2019-11-01","2019-10-01","2019-09-01","2019-08-01","2019-06-01","2019-05-01","2019-04-01","2019-03-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-01-01","2020-01-01","2019-12-01","2019-11-01","2019-10-01","2019-09-01","2019-07-01","2019-06-01","2019-05-01","2019-04-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-02-01","2020-02-01","2020-01-01","2019-12-01","2019-11-01","2019-10-01","2019-08-01","2019-07-01","2019-06-01","2019-05-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-03-01","2020-03-01","2020-02-01","2020-01-01","2019-12-01","2019-11-01","2019-09-01","2019-08-01","2019-07-01","2019-06-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-04-01","2020-04-01","2020-03-01","2020-02-01","2020-01-01","2019-12-01","2019-10-01","2019-09-01","2019-08-01","2019-07-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-05-01","2020-05-01","2020-04-01","2020-03-01","2020-02-01","2020-01-01","2019-11-01","2019-10-01","2019-09-01","2019-08-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-06-01","2020-06-01","2020-05-01","2020-04-01","2020-03-01","2020-02-01","2019-12-01","2019-11-01","2019-10-01","2019-09-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-07-01","2020-07-01","2020-06-01","2020-05-01","2020-04-01","2020-03-01","2020-01-01","2019-12-01","2019-11-01","2019-10-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-08-01","2020-08-01","2020-07-01","2020-06-01","2020-05-01","2020-04-01","2020-02-01","2020-01-01","2019-12-01","2019-11-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-09-01","2020-09-01","2020-08-01","2020-07-01","2020-06-01","2020-05-01","2020-03-01","2020-02-01","2020-01-01","2019-12-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-10-01","2020-10-01","2020-09-01","2020-08-01","2020-07-01","2020-06-01","2020-04-01","2020-03-01","2020-02-01","2020-01-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-11-01","2020-11-01","2020-10-01","2020-09-01","2020-08-01","2020-07-01","2020-05-01","2020-04-01","2020-03-01","2020-02-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-12-01","2020-12-01","2020-11-01","2020-10-01","2020-09-01","2020-08-01","2020-06-01","2020-05-01","2020-04-01","2020-03-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2021-01-01","2021-01-01","2020-12-01","2020-11-01","2020-10-01","2020-09-01","2020-07-01","2020-06-01","2020-05-01","2020-04-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2021-02-01","2021-02-01",null,"2020-12-01","2020-11-01","2020-10-01","2020-08-01","2020-07-01","2020-06-01","2020-05-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2021-03-01","2021-03-01",null,null,"2020-12-01","2020-11-01","2020-09-01","2020-08-01","2020-07-01","2020-06-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-01-01","2020-07-01"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2020-02-01"]

{"sheet":"Pg 2 Gp Sz Determination Form","index":2,"n_rows":66,"n_cols":12,"rows_kept":66,"cut":false,"hidden":false,"merged":[[4,0,4,11],[5,0,5,11],[6,0,6,11],[7,0,7,9],[7,10,7,11],[9,0,9,11],[11,0,11,9],[12,0,12,9],[13,0,13,9],[13,10,14,10],[14,0,14,9],[15,0,15,9],[15,10,16,10],[16,0,16,9],[20,0,20,9],[20,12,21,12],[21,0,21,9],[22,0,22,9],[23,0,23,9],[24,0,24,9],[25,0,25,9],[30,0,30,9],[31,0,31,9],[34,0,34,9],[35,0,35,9],[37,0,37,9],[38,0,38,9],[39,0,39,9],[40,0,40,9],[40,10,41,10],[40,11,41,11],[41,0,41,9],[54,11,55,11],[42,0,42,9],[43,0,43,9],[44,0,44,9],[45,0,45,9],[45,10,45,11],[46,0,48,9],[46,10,48,10],[49,0,49,9],[49,10,49,11],[50,0,51,11],[54,0,54,9],[54,10,55,10],[56,0,56,11],[58,10,59,10],[58,11,59,11],[62,0,62,11],[66,0,66,11]]}
[]
[]
[]
[]
["Group Size Determination Form"]
["This form must be completed for all new and renewing groups to determine whether a group is a large employer."]
["Controlled and Affiliated Groups:\n\n\nAre you a Controlled Group?"]
["Are you a Controlled Group? "]
[]
["If you are a controlled or affiliated group of employers as described under subsection (b), (c), (m) or (o) of section 414 of the Internal Revenue Code of 1986, Moda Health must treat all employees within the affiliated group as a single group for purposes of determining group size. You must fill out one group profile form for the entire controlled group. If a controlled group is\ndetermined as a large employer, each affiliated employer is part of the large employer even if separately the employer would\nnot meet the definition of large employer. Therefore, each affiliated employer is considered a large group for the purposes of\ngroup size determination.\n\nEmployee Counting Instructions:\na) Total the number of employees working 130 hours for each month of the preceding calendar year.\nb) Total the number of hours worked by employees working less than 130 hours for each month of the preceding calendar\nyear, but do not include more than 120 hours per employee in a month and divide by 120. This is your Full Time\nEquivalent (FTE) count of the preceding calendar year.\nc) Add the numbers from a and b together and divide by 12. This is your group size.\n\nWhen counting employees to determine group size, do not count a sole proprietor, a partner in a partnership, a 2‐percent\nS corporation shareholder, or the spouse of a person who is a sole proprietor, a temporary, seasonal, leased or contracted\nemployee, a retired employee, or former employee on continuation coverage."]
["SECTION A"]
["Is this an employee only plan?"]
["1.  On average, how many full time employees did the employer have during the preceding\ncalendar year? Total the number of employees working 130 hours or more for each month of the preceding\ncalendar year and divide by 12."]
["2.  On average how many Full Time Equivalent (FTE) employees did the employer have during the\npreceding calendar year. Total the number of hours worked by employees working less than 130 hours for\neach month of the preceding calendar year, but do not include more than 120 hours per employee in a month and divide by 120. Then divide the total number by 12."]
[]
["3.  Total employee count (for determining group size) (#1+#2)\nIf less than 1, no Oregon small group exists. If more than 50, the group is a large group and not eligible as an Oregon small group. If 1 to 50, the group is a small group.\n",null,null,null,null,null,null,null,null,null,{"$f":"K13+K14","v":0}]
[]
[]
[]
[]
["4. How many employees does the employer expect to have on the date coverage will take effect?\nThe employer must have at least one common law employee enrolled on the date coverage will take effect in order to be issued small group coverage.\n"]
["  "]
["5. How many employees will be eligible for coverage based on the group's eligibility rules?"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,{"$f":"IF(K23=\"\",\"\",K23-#REF!)","v":""},{"$f":"IF(K23=\"\",\"\",K23-#REF!)","v":""}]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"Medical","Dental"]
["6.  Out of the number of employees indicated in question #5, indicate the number of employees waiving due to other group or individual coverage:"]
[]
[]
["7.  Total employee count (for participation requirement)  (#5 - #6):",null,null,null,null,null,null,null,null,null,{"$f":"K23-K35","v":0},{"$f":"K23-L35","v":0}]
[]
[]
["8.  Out of the number of employees indicated in question #7, indicate the number of employees opting out of coverage: \nCount employees choosing not to take coverage here."]
[]
["9.  Total number of employees enrolling (#7 - #8):",null,null,null,null,null,null,null,null,null,{"$f":"K38-K41","v":0},{"$f":"L38-L41","v":0}]
["10.  Total number of COBRA or state continuation enrollees (include primary insured's only)"]
["11. Total number of employees and COBRA or state continuation enrollees (#9 + #10)",null,null,null,null,null,null,null,null,null,{"$f":"K43+K44","v":0},{"$f":"L43+L44","v":0}]
["12. To determine if your group is subject to COBRA, indiciate how many employees you employed on a typical business day in the previous calendar year: \nDo not count self-employed individuals, independent contractors, and members of the board of directors. (If the group had 20 or more employees during at least 50% of the previous calendar year, the plan qualifies for COBRA continuation). Otherwise, the group qualifies for state continuation."]
["13.  What type of employees are you offering coverage to:\n       a. All employees working 17.5 hours or more per week\n       b. All employees working the minimum hours required by your specific company\n          in order to qualify for benefits (i.e. 40 hours per week)\n       \n"]
[]
[]
["14.  To determine if your group is subject to Medicare Secondary Payer provision, do you have 20 or more employees for each working day in each 20 or more calendar weeks in the current calendar year or the preceding calendar year? \nCount all employees on the employment payroll. Do not count retirees, COBRA qualified beneficiaries, individuals on other continuation options or self-employed individuals.\n      ",null,null,null,null,null,null,null,null,null,"Yes"]
["Comments: "]
[]
[]
["EMPLOYEE PARTICIPATION",null,null,null,null,null,null,null,null,null,"Medical","Dental"]
["15.  What percentage of employees participate in the plan(s)?  (#9 divided by #7) \nFor Voluntary Dental Plans, a minimum of 25% of eligible employees must participate with a minimum of 10 enrolling.",null,null,null,null,null,null,null,null,null,{"$f":"K43/K38","v":{"$error":"#DIV/0!"}},{"$f":"L43/L38","v":{"$error":"#DIV/0!"}}]
[]
["If you checked \"yes\" to EMPLOYEE ONLY PLAN on page 1, please mark \"N/A\" for dependent participation in question #16 below.  Please note that under an employee only contract, Moda will not allow any future dependents to be covered on this plan.\nIf you checked \"no\" to EMPLOYEE ONLY PLAN on page 1, but currently have no eligible dependents to enroll, please indicate 0% for dependent participation in question #16 below.  Please note that under an employee + dependent contract, Moda will allow any future dependents to be covered on this plan.\nIf you checked \"no\" to EMPLOYEE ONLY PLAN on page 1, and currently have eligible dependents to enroll, please calculate your current dependent participation and indicate this percentage in question #16 below.  Please note that under an employee + dependent contract, Moda will allow any future dependents to be covered on this plan.\n"]
["DEPENDENT PARTICIPATION",null,null,null,null,null,null,null,null,null,"Medical","Dental"]
["16.  What percentage of dependents participate in the plan(s)?",null,null,null,null,null,null,null,null,null,"%","%"]
[]
["SECTION B"]
[]
["To the best of my knowledge, I certify that all the information contained herein is correct.  I understand that the final rates will be based on actual enrollment and may be different than the rates originally quoted and that additional information may be required to verify eligibility of the group."]
["I am the:"]
[]
["Name (printed please)",null,null,null,null,"Signature",null,null,null,null,"Date:"]

{"sheet":"Page 3 - Plan Info","index":3,"n_rows":28135,"n_cols":177,"rows_kept":562,"cut":true,"hidden":false,"merged":[[29,1,29,5],[41,2,41,5],[49,9,49,11],[46,0,46,9],[34,10,34,11],[45,7,45,11],[41,7,41,11],[43,2,43,5],[43,7,43,11],[34,1,34,2],[29,7,29,11],[51,9,51,11],[47,0,47,10],[48,9,48,11],[50,9,50,11],[45,2,45,5],[24,1,24,2],[4,0,4,1],[15,0,15,3],[16,0,16,3],[14,0,14,1],[11,0,11,1],[23,1,23,2],[13,1,13,3],[22,8,22,11],[12,0,12,1],[20,1,20,4],[2,8,2,11],[14,4,14,6],[14,9,14,11],[2,3,2,7],[4,10,4,11],[11,11,11,12],[5,8,5,9],[28,7,28,11],[30,9,30,11],[3,0,3,1],[10,10,10,12],[10,6,10,9],[3,10,3,11],[6,0,6,2],[10,2,10,5],[7,0,7,3],[8,0,8,3],[24,10,24,11],[19,1,19,4],[22,5,22,7],[20,7,20,9],[26,1,26,5],[15,9,15,11],[55,9,55,11],[53,9,53,11],[12,11,12,12],[7,5,7,6],[8,5,8,6],[15,5,15,6],[16,5,16,6],[19,5,19,8],[19,10,19,11],[34,8,34,9],[33,8,33,9],[33,10,33,11],[28,1,28,5],[23,10,23,11],[25,9,25,11],[33,1,33,2]],"bounds":{"rows_first":250,"rows_last":62,"rows_between":250,"halvings":3}}
["Types of Coverage: "]
[]
["Medical:",null,null,"In-Network",null,null,null,null,"Out-of-Network",null,null,null,"Group Size"]
["Moda Health Standard Plan Design #",null,"Plan Type","Deductible","Co-ins.    %","Co-pay","Hospital Co-pay","Out-of-Pocket","Ded","Co-ins.    %","Out-of-Pocket",null,"Large"]
[null,null,{"$f":"IFERROR(VLOOKUP(LEFT(A5,1),'Plan Info Lookups'!$B$59:$C$69,2,FALSE),\"\")","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,5,1),'Plan Info Lookups'!$M$59:$N$79,2,FALSE),\"\")","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,6,1),'Plan Info Lookups'!$S$59:$T$66,2,FALSE),\"\")","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,3,2),'Plan Info Lookups'!$G$59:$H$68,2,FALSE),\"\")","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,6,1),'Plan Info Lookups'!$S$59:$T$66,2,FALSE),\"\")","v":""},{"$f":"IF(A5=\"\",\"\",IFERROR(VLOOKUP(MID(A5,7,2),'Plan Info Lookups'!$Z$59:$AA$95,2,FALSE),\"Error\"))","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,10,1),'Plan Info Lookups'!$M$59:$N$90,2,FALSE),\"\")","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,11,1),'Plan Info Lookups'!$S$59:$T$65,2,FALSE),\"\")","v":""},{"$f":"IFERROR(VLOOKUP(MID(A5,12,2),'Plan Info Lookups'!$Z$59:$AA$117,2,FALSE),\"\")","v":""},{"$f":"IF($A$5=\"\",\"\",IF(VLOOKUP($A$5,$EC$7:$EK$29885,1)=$A$5,VLOOKUP($A$5,$EC$7:$EK$29885,2),\"\"))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2014 plan option -- all inclusive"]
[null,null,null,null,null,null,null,null,"No",null,"Maximum Cost Share Wrap",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PlanID","PlanID","Plan Type"," Copay"," In Deductible"," In Coinsurance"," In OOP Max"," Out Deductible"," Out Coinsurance"," Out OOP Max"]
["Select all networks accessed:",null,null,"Connexus",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-002202-0000","1-002202-0000","Oregon - Indemnity (51+)","No Copay","$250 Ded","20%","($2,000)","No Ded","0%","No OOP Max"]
["Is this a Non-Standard/Negotiated Plan Design?",null,null,null," (Y/N):",null,null,"Please attach benefit summary if plan is Non-Standard/Negotiated",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-002203-0000","1-002203-0000","Oregon - Indemnity (51+)","No Copay","$250 Ded","20%","($3,000)","No Ded","0%","No OOP Max"]
["Are there grandfathered benefits?",null,null,null," (Y/N):",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"","Add New Class",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-002205-0000","1-002205-0000","Oregon - Indemnity (51+)","No Copay","$250 Ded","20%","($5,000)","No Ded","0%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Add New Subgroup",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-005203-0000","1-005203-0000","Oregon - Indemnity (51+)","No Copay","$500 Ded","20%","($3,000)","No Ded","0%","No OOP Max"]
["Pharmacy:",null,"Retail",null,null,null,"Mail Order",null,null,null,"Retail & Mail Order - (Specify):",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Change",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-005205-0000","1-005205-0000","Oregon - Indemnity (51+)","No Copay","$500 Ded","20%","($5,000)","No Ded","0%","No OOP Max"]
["Moda Health Standard Plan Design#",null,"Value Co-pay","Select                   Co-pay","Preferred Co-pay","Non-Preferred Co-pay","Value                   Co-pay","Select                  Co-pay","Preferred Co-pay","Non-Preferred Co-pay","Ded","Out-of-Pocket",null,null,null,null,null,null,null,null,null,null,null,false,null,null,null,"Renewal",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-008205-0000","1-008205-0000","Oregon - Indemnity (51+)","No Copay","$2,500 Ded","20%","($5,000)","No Ded","0%","No OOP Max"]
[null,null,{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,14),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",(IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,5),\"\")))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,9),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,10),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,15),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,7),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,11),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,12),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,16),\"\"))","v":""},{"$f":"IF($A$13=\"\",\"\",IF(I6=\"Yes- $6850/$13700\",\"See Max Cost Share\",IF(VLOOKUP($A$13,$EP$71:$FE$127,1)=$A$13,VLOOKUP($A$13,$EP$71:$FE$127,13),\"\")))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NEW",null,"NEW",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-009203-0000","1-009203-0000","Oregon - Indemnity (51+)","No Copay","$1,000 Ded","20%","($3,000)","No Ded","0%","No OOP Max"]
[null,{"$f":"IF(A5=\"\",\"\",IF(LEFT(A5,1)=\"H\",\"HSA Plan Rx:\",\"\"))","v":""},null,null,{"$f":"IF(A5=\"\",\"\",IF(LEFT(A5,1)=\"H\",\"Deductible Applies, then \"&(E5),\"\"))","v":""},null,null,null,"Include Moda Health Enhanced Specialty Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Reinstate (include diary & renewal)",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-009205-0000","1-009205-0000","Oregon - Indemnity (51+)","No Copay","$1,000 Ded","20%","($5,000)","No Ded","0%","No OOP Max"]
["Contraceptive Coverage:",null,null,"Type of Coverage:",null,null,null,null,"Diabetic Supplies:",null,null,null,null,null,null,null,"Connexus",null,null,null,null,null,null,null,null,null,null,"Renewal",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1300","2-001104-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","30%","No OOP Max"]
["Is this a Non-Standard/Negotiated Plan Design?",null,null,null," (Y/N):",null,null,null,"Modified from Plan #:",null,null,null,null,null,null,null,"PHCS",null,null,null,null,null,null,null,null,null,null,"Renewal / New LOB",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1365","2-001104-1365","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","30%","($6,500)"]
["Are there grandfathered benefits?",null,null,null," (Y/N):",null,null,null,null,null,null,null,null,null,null,null,"First Choice",null,null,null,null,null,null,null,null,null,null,"Revised Renewal",null,"Renewal",1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1365","2-001104-1365","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","30%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"First Choice HIN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,"New Pool",12,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1400","2-001104-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","40%","No OOP Max"]
["Vision:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"MHN",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,"Renewal Pool",30,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1465","2-001104-1465","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","40%","($6,500)"]
["Moda Health Standard Plan Design #","Plan Type",null,null,null,"Is this a Non-Standard/Negotiated Plan Design?",null,null,null," (Y/N):",null,null,null,null,null,null,"Synergy",null,null,null,null,null,null,null,null,null,{"$f":"IF(C20=\"\",\"\",IF(C20=\"51-99\",1,IF(C20=\"100+\",3,0)))","v":""},51,99,"Pool",1,null,null,null,3,"New Experience",60,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1465","2-001104-1465","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","40%","($6,500)"]
[null,{"$f":"IF($A$21=\"\",\"\",IF(VLOOKUP($A$21,$AJ$334:$AK$344,1)=$A$21,VLOOKUP($A$21,$AJ$334:$AK$344,2),\"\"))","v":""},null,null,null,null,"Modified from Plan #:",null,null,null,null,null,null,null,null,null,"Summit",null,null,null,null,null,null,null,null,null,null,100,50000,"Experience",3,null,null,null,4,"Renewal Experience",60,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1500","2-001104-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Travel Network (Applies to ASO)",null,{"$f":"+A22","v":0},null,null,null,null,null,null,null,{"$f":"IF(OR(AA9=\"\",AA20=\"\"),\"\",SUM(AA8:AA20))","v":""},null,null,null,{"$f":"SUM(AE9:AE21)","v":13},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1565","2-001104-1565","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","50%","($6,500)"]
["Dental:","Group Size:","51-99",null,null,"In-Network",null,null,"Out-of-Network",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001104-1565","2-001104-1565","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,000)","$1,500 Ded","50%","($6,500)"]
["Delta Dental Standard Plan Design#","Plan Type",null,"Deductible","Maximum","Preventive","Basic","Major","Preventive","Basic","Major",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1300","2-001105-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","No OOP Max"]
[null,{"$f":"IF($A$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,2,FALSE))","v":""},"",{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,3,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,7,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,4,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,5,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,6,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,8,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,9,FALSE))","v":""},{"$f":"IF($B$25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$DI$619,10,FALSE))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1300","2-001105-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","No OOP Max"]
[null,"Non-Standard/Negotiated Plan Design.  Please note changes in ITALICS & BOLD.  ",null,null,null,null,null,null,"Modified from Plan #:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1309","2-001105-1309","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","($9,000)"]
[null,"Mercer Marketplace Group - Non-Par MPA80 Pricing",null,null,null,null,"No",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1309","2-001105-1309","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","($9,000)"]
["Orthodontia:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1310","2-001105-1310","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","($10,000)"]
["Delta Dental Standard Plan Design#","Plan Type",null,null,null,null,"Other:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1315","2-001105-1315","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","($15,000)"]
[null,{"$f":"IF($A$30=\"\",\"\",IF(VLOOKUP($A$30,$CZ$62:$DC$78,1)=$A$30,VLOOKUP($A$30,$CZ$62:$DC$78,2),\"\"))","v":""},"","","",null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(A30=\"Direct Option:\",TRUE,FALSE)","v":false},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1400","2-001105-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","No OOP Max"]
[null,"Non-Standard/Negotiated Plan Design.  Please note changes in ITALICS & BOLD.  ",null,null,null,null,null,null,"Modified from Plan #:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1400","2-001105-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1409","2-001105-1409","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","($9,000)"]
[{"$f":"IF(OR(C23=\"100+\",A25=\"\"),\"Direct Option:\",IF(VLOOKUP(A25,$CB$215:$CB$261,1)=A25,\"Direct Option Match:\",\"Direct Option:\"))","v":"Direct Option:"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1409","2-001105-1409","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","($9,000)"]
["Delta Dental Standard Plan Design#","Plan Type",null,"Deductible","Maximum","Prev/ Diag","Surgical Extractions","Crowns","Other",null,"Ortho",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1410","2-001105-1410","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","($10,000)"]
[{"$f":"IF(OR(C23=\"100+\",LEFT($A$25,1)=\"VB\"),\"\",IF(OR(C33=\"VDO1F\",C33=\"VDO2F\"),VLOOKUP(C33,$CE$99:$CX$100,1),IF(A25=\"\",\"\",VLOOKUP($A$25,$CZ$315:$ES$619,45,FALSE))))","v":""},{"$f":"IF($A$35=\"\",\"\",IF(OR(C33=\"VDO1F\",C33=\"VDO2F\"),VLOOKUP(C33,$CE$99:$CX$100,2),VLOOKUP($A$25,$CZ$315:$ES$619,46,FALSE)))","v":""},{"$f":"IF(C29=\"\",\"\",C29&\" MATCH\")","v":""},{"$f":"IF($A$35=\"\",\"\",\"$0 Ded\")","v":""},{"$f":"IF($A$35=\"\",\"\",\"None\")","v":""},{"$f":"IF($A$35=\"\",\"\",IF(OR(C33=\"VDO1F\",C33=\"VDO2F\"),VLOOKUP(C33,$CE$99:$CX$100,11),IF(LEFT($A$25,1)=\"VB\",\"\",VLOOKUP($A$25,$CZ$315:$ES$619,22,FALSE))))","v":""},{"$f":"IF($A$35=\"\",\"\",IF(OR(C33=\"VDO1F\",C33=\"VDO2F\"),VLOOKUP(C33,$CE$99:$CX$100,18),IF(LEFT($A$25,1)=\"VB\",\"\",VLOOKUP($A$25,$CZ$315:$ES$619,43,FALSE))))","v":""},{"$f":"IF($A$35=\"\",\"\",IF(OR(C33=\"VDO1F\",C33=\"VDO2F\"),VLOOKUP(C33,$CE$99:$CX$100,12),IF(LEFT($A$25,1)=\"VB\",\"\",VLOOKUP($A$25,$CZ$315:$ES$619,23,FALSE))))","v":""},{"$f":"IF($A$35=\"\",\"\",\"See Summary\")","v":""},null,{"$f":"IF($A$35=\"\",\"\",\"$2,800 Copay\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1415","2-001105-1415","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1500","2-001105-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1500","2-001105-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1509","2-001105-1509","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1509","2-001105-1509","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","50%","($9,000)"]
["EXISTING COVERAGE:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1510","2-001105-1510","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","50%","($10,000)"]
["1.  Please provide the previous carrier(s) name and contact phone number:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001105-1515","2-001105-1515","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","50%","($15,000)"]
[null,"Medical:",null,null,null,null,"Dental:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1300","2-001106-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","30%","No OOP Max"]
["2.  Please provide the name and contact phone number for the current insurance carrier(s), both medical and dental:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1313","2-001106-1313","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","30%","($10,500)"]
[null,"Medical:",null,null,null,null,"Dental:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1313","2-001106-1313","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","30%","($10,500)"]
["3. If dual coverage is available, please list the other carrier(s):",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1400","2-001106-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","40%","No OOP Max"]
[null,"Medical:",null,null,null,null,"Dental:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1413","2-001106-1413","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","40%","($10,500)"]
["4. If this plan is replacing an existing plan, will members receive credit from the previous plan?",null,null,null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1413","2-001106-1413","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","40%","($10,500)"]
["If Yes, check the type(s) of report(s) below that will be available for applying credit:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1500","2-001106-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,"Medical deductible:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1513","2-001106-1513","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,"Medical Out-of-pocket:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001106-1513","2-001106-1513","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,000)","$1,500 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,"Dental deductible:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1300","2-001125-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,"Accumulator Report:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1335","2-001125-1335","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","30%","($3,500)"]
["5. If enrolling in Dental Plan A (incentive plan), will benefits for members who were covered under the",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A_7_1_2009","B_1_1_2010",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1335","2-001125-1335","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","30%","($3,500)"]
["     group's prior plan begin at the first year benefit level?",null,null,null,null,null,null,null,"(Y/N):",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1400","2-001125-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1435","2-001125-1435","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","40%","($3,500)"]
[null,null,"If No, select the benefit level that will apply to existing members:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1435","2-001125-1435","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","40%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1500","2-001125-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1535","2-001125-1535","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001125-1535","2-001125-1535","Oregon - PPO","No Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,2,3,4,5,6,7,8,9,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1300","2-001135-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"OUT-CLASS1","OUT-CLASS2","OUT-CLASS3","OV","Crowns/Bridges/Pontics/Inlays/Onlays","Root Canals","Root Planing","Gingivectomy","Dentures Full","Dentures Partial","Surg Extractions","Nitrous Oxide",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1355","2-001135-1355","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","30%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A0",null,null,null,null,null,"A0_7_1_2012","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1C_7_1_2012","Direct Option 1","A1000","ADULT - 50% UP TO $1,000 LIFETIME MAXIMUM",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1355","2-001135-1355","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","30%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X25",null,null,null,null,null,"A0_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","A1500","ADULT - 50% UP TO $1,500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,{"$f":"+CX63&$CY$53","v":"DO1A_7_1_2009A_7_1_2009"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1400","2-001135-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X50",null,null,null,null,null,"B3X25_7_1_2012","PREMIER OPTION B","$25/$75 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1C_7_1_2012","Direct Option 1","A2000","ADULT -  50% UP TO $2,000 LIFETIME MAXIMUM",null,null,null,null,null,null,null,{"$f":"+CX64&$CY$53","v":"DO1C_7_1_2012A_7_1_2009"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1455","2-001135-1455","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X501",null,null,null,null,null,"B3X25_7_1_2009","PREMIER OPTION B","$25/$75 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","A2500","ADULT -  50% UP TO $2,500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO1A_7_1_2009A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1455","2-001135-1455","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X502",null,null,null,null,null,"B3X50_7_1_2012","PREMIER OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1C_7_1_2012","Direct Option 1","A500","ADULT - 50% UP TO $500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO1C_7_1_2012A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1500","2-001135-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X25",null,null,null,null,null,"B3X50_7_1_2009","PREMIER OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","AC1000","ADULT & CHILD - 50% UP TO $1,000 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO1A_7_1_2009A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1555","2-001135-1555","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","50%","($5,500)",null,null,null,"2014 plan options","2014 plan options"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X50",null,null,null,null,null,"B3X501_7_1_2012","PREMIER OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3C_7_1_2012","Direct Option 3","AC1500","ADULT & CHILD - 50% UP TO $1,500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO3C_7_1_2012A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001135-1555","2-001135-1555","Oregon - PPO","No Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","50%","($5,500)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RX01525502XC90","Rx: PBM: $0/$15/$25/50%; Mail Order: $0/$30/$50/50% (w/ contra.)",null,null,"$15","$25/50%","$30","$50/50%","$25","50%","$50","50%","N/A","$0","$0"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X501",null,null,null,null,null,"B3X501_7_1_2009","PREMIER OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","AC2000","ADULT & CHILD - 50% UP TO $2,000 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO3A_7_1_2009A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1300","2-001145-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","30%","No OOP Max",null,null,null,"Discount Card","Discount Card",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RX01535502XC90","Rx: PBM: $0/$15/$35/50%; Mail Order: $0/$30/$70/50% (w/ contra.)",null,null,"$15","$35/50%","$30","$70/50%","$35","50%","$70","50%","N/A","$0","$0"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X25",null,null,null,null,null,"B3X502_7_1_2012","PREMIER OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1C_7_1_2012","Direct Option 1","AC2500","ADULT & CHILD - 50% UP TO $2,500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO1C_7_1_2012A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1375","2-001145-1375","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","30%","($7,500)",null,null,null,"Modified","Modified",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RX1020%502XC90","Rx: PBM: $10/20%/50%; Mail Order: $20/20%/50% (w/ contra.)",null,null,"$10","20%/50%","$20","20%/50%","20%","50%","20%","50%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X50",null,null,null,null,null,"B3X502_7_1_2009","PREMIER OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","AC500","ADULT & CHILD - 50% UP TO $500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO1A_7_1_2009A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1375","2-001145-1375","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","30%","($7,500)",null,null,null,"RX1020%502XC90","","",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RX1020502XC90","Rx: PBM: $10/$20/50%; Mail Order: $20/$40/50% (w/ contra.)",null,null,"$10","$20/50%","$20","$40/50%","$20","50%","$40","50%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X501",null,null,null,null,null,"BP3X25_7_1_2012","PPO OPTION B","$25/$75 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3C_7_1_2012","Direct Option 3","C1000","CHILD ONLY - 50% UP TO $1,000 LIFETIME MAXIMUM",null,null,null,null,null,null,null,"DO3C_7_1_2012A_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1400","2-001145-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX1020502XC90","","",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RX1025502XC90","Rx: PBM: $10/$25/50%; Mail Order: $20/$50/50% (w/ contra.)",null,null,"$10","$25/50%","$20","$50/50%","$25","50%","$50","50%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X501",null,null,null,null,null,"BP3X25_7_1_2009","PPO OPTION B","$25/$75 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","C1500","CHILD ONLY - 50% UP TO $1,500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,{"$f":"+CX73&$CY$53","v":"DO3A_7_1_2009A_7_1_2009"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1475","2-001145-1475","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","40%","($7,500)",null,null,null,"RX1025$502XC90","","",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RX1030502XC90","Rx: PBM: $10/$30/$50; Mail Order: $20/$60/$100 (w/ contra.)",null,null,"$10","$30/$50","$20","$60/$100","$30","$50","$60","$100","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E01",null,null,null,null,null,"BP3X50_7_1_2012","PPO OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3C_7_1_2012","Direct Option 3","C2000","CHILD ONLY - 50% UP TO $2,000 LIFETIME MAXIMUM",null,null,null,null,null,null,null,{"$f":"+CX74&$CY$53","v":"DO3C_7_1_2012A_7_1_2009"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1475","2-001145-1475","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","40%","($7,500)",null,null,null,"RX1025502XC90","RX_10_20%_50%_3X","Rx: PBM:$10/20%/50%; Mail Order: $30/20%/50% (w/ contra.)",null,null,"$10","20%/50%","$30","20%/50%","20%","50%","20%","50%","Combined (Refer to Medical OOP)","-","-","-","RX1035502XC90","Rx: PBM: $10/$35/$50; Mail Order: $20/$70/$100 (w/ contra.)",null,null,"$10","$35/$50","$20","$70/$100","$35","$50","$70","$100","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A0",null,null,null,null,null,"BP3X50_7_1_2009","PPO OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","C2500","CHILD ONLY - 50% UP TO $2,500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1500","2-001145-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX1030502XC90","RX_10_20_50%_3X","Rx: PBM: $10/$20/50%; Mail Order: $30/$60/50% (w/ contra.)",null,null,"$10","$20/50%","$30","$60/50%","$20","50%","$60","50%","Combined (Refer to Medical OOP)","-","-","-","RX1040602XC90","Rx: PBM: $10/$40/$60; Mail Order: $20/$80/$120 (w/ contra.)",null,null,"$10","$40/$60","$20","$80/$120","$40","$60","$80","$120","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X25",null,null,null,null,null,"BP3X501_7_1_2012","PPO OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4C_7_1_2012","Direct Option 4","C500","CHILD ONLY - 50% UP TO $500 LIFETIME MAXIMUM",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1575","2-001145-1575","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","50%","($7,500)",null,null,null,"RX1035502XC90","RX_10_25_50%_3X","Rx: PBM: $10/$25/50%; Mail Order: $30/$75/50% (w/ contra.)",null,null,"$10","$25/50%","$30","$75/50%","$25","50%","$75","50%","Combined (Refer to Medical OOP)","-","-","-","RX1525$502XC90","Rx: PBM: $15/$25/$50; Mail Order: $30/$50/$100 (w/ contra.)",null,null,"$15","$25/$50","$30","$50/$100","$25","$50","$50","$100","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X50",null,null,null,null,null,"BP3X501_7_1_2009","PPO OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4A_7_1_2009","Direct Option 4","VCO1000","CHILD ONLY - 50% UP TO $1,000 LIFETIME MAX W/ 18 MONTH EXCLUSION",null,null,null,null,null,null,"18 MONTH EXCLUSION PERIOD",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001145-1575","2-001145-1575","Oregon - PPO","No Copay","$1,500 Ded","10%","($4,500)","$1,500 Ded","50%","($7,500)",null,null,null,"RX1040602XC90","RX_10_25_50_3X","Rx: PBM: $10/$25/$50; Mail Order: $30/$75/$150 (w/ contra.)",null,null,"$10","$25/$50","$30","$75/$150","$25","$50","$75","$150","Combined (Refer to Medical OOP)","-","-","-","RX1525502XC90","Rx: PBM: $15/$25/50%; Mail Order: $30/$50/50% (w/ contra.)",null,null,"$15","$25/50%","$30","$50/50%","$25","50%","$50","50%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X501",null,null,null,null,null,"BPA3X50_7_1_2012","PPO OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","90%","50%","$1,500","90%(Ded. wavied)","70%","50%","$10 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO2C_7_1_2012","Direct Option 2","VCO1500","CHILD ONLY - 50% UP TO $1,500 LIFETIME MAX W/ 18 MONTH EXCLUSION",null,null,null,null,null,null,"18 MONTH EXCLUSION PERIOD",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1300","2-001155-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","30%","No OOP Max",null,null,null,"RX1525$502XC90","RX_10_30_50_3X","Rx: PBM: $10/$30/$50; Mail Order: $30/$90/$150 (w/ contra.)",null,null,"$10","$30/$50","$30","$90/$150","$30","$50","$90","$150","Combined (Refer to Medical OOP)","-","-","-","RX15502XC90","Rx: PBM $15 or 50% (whichever's greater) w/ $30 or 50% (whichever's greater) Mail Order",null,null,"$15/50%","$15/50%","$30/50%","$30/50%","$15/50%","$15/50%","$30/50%","$30/50%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X502",null,null,null,null,null,"BPB3X50_7_1_2012","PPO OPTION B","$50/$150 Deductible (waived on Preventive)","100%(Ded. wavied)","80%","50%","$1,500","90%(Ded. wavied)","70%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3C_7_1_2012","Direct Option 3",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1310","2-001155-1310","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","30%","($10,000)",null,null,null,"RX1525502XC90","RX_10_35_50_3X","Rx: PBM: $10/$35/$50; Mail Order: $30/$105/$150 (w/ contra.)",null,null,"$10","$35/$50","$30","$105/$150","$35","$50","$105","$150","Combined (Refer to Medical OOP)","-","-","-","RX21030502XC90","Rx: PBM: $2/$10/$30/$50; Mail Order: $4/$20/$60/$100 (w/ contra.)",null,null,"$10","$30/$50","$20","$60/$100","$30","$50","$60","$100","N/A","$2","$4"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X25",null,null,null,null,null,"C3X25_7_1_2012","PREMIER OPTION C","$25/$75 Deductible","80%","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO2C_7_1_2012","Direct Option 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1310","2-001155-1310","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","30%","($10,000)",null,null,null,"RX15502XC90","RX_10_40_60_3X","Rx: PBM: $10/$40/$60; Mail Order: $30/$120/$180 (w/ contra.)",null,null,"$10","$40/$60","$30","$120/$180","$40","$60","$120","$180","Combined (Refer to Medical OOP)","-","-","-","RX21035502XC90","Rx: PBM: $2/$10/$35/$50; Mail Order: $4/$20/$70/$100 (w/ contra.)",null,null,"$10","$35/$50","$20","$70/$100","$35","$50","$70","$100","N/A","$2","$4"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X50",null,null,null,null,null,"C3X25_7_1_2009","PREMIER OPTION C","$25/$75 Deductible","80%","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO2A_7_1_2009","Direct Option 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1400","2-001155-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX250D15DW25502XC90","RX_15_25_50%_3X","Rx: PBM: $15/$25/50%; Mail Order: $45/$75/50% (w/ contra.)",null,null,"$15","$25/50%","$45","$75/50%","$25","50%","$75","50%","Combined (Refer to Medical OOP)","-","-","-","RX21040602XC90","Rx: PBM: $2/$10/$40/$60; Mail Order: $4/$20/$80/$120 (w/ contra.)",null,null,"$10","$40/$60","$20","$80/$120","$40","$60","$80","$120","N/A","$2","$4"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X501",null,null,null,null,null,"C3X50_7_1_2012","PREMIER OPTION C","$50/$150 Deductible","80%","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO2C_7_1_2012","Direct Option 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1410","2-001155-1410","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","40%","($10,000)",null,null,null,"RX25CA90","RX_15_25_50_3X","Rx: PBM: $15/$25/$50; Mail Order: $45/$75/$150 (w/ contra.)",null,null,"$15","$25/$50","$45","$75/$150","$25","$50","$75","$150","Combined (Refer to Medical OOP)","-","-","-","RX250D215DW25502XC90","Rx: PBM: $250 Ded, $2/$15 (Ded waived for Value/Generics)/$25/50% , 2x Mail Order Copay",null,null,"$15 (Ded wvd)","$25/50%","$30 (Ded wvd)","$50/50%","$25","50%","$50","50%","N/A","$2 (Ded wvd)","$4 (Ded wvd)","$250Ded (wvd value/gen)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X25",null,null,null,null,null,"C3X50_7_1_2009","PREMIER OPTION C","$50/$150 Deductible","80%","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO2A_7_1_2009","Direct Option 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1410","2-001155-1410","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","40%","($10,000)",null,null,null,"RX30CA90","RX_15_50%_3X","Rx: PBM $2 Value,$15 or 50% (whichever's greater) w/$6 Value, $45 or 50% (whichever's greater) Mail Order",null,null,"$15/50%","$15/50%","$45/50%","$45/50%","$15/50%","$15/50%","$45/50%","$45/50%","Combined (Refer to Medical OOP)","$2","$6","-","RX25CA90","Rx: PBM: $5/20%; Mail Order: $5/20% (w/ contra.)",null,null,"$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X50",null,null,null,null,null,"C3X501_7_1_2012","PREMIER OPTION C","$50/$150 Deductible","80%","80%","50%","$1,000","N/A","N/A","N/A","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4C_7_1_2012","Direct Option 4",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1500","2-001155-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX35CA90","RX_2_10_20%_50%_3X","Rx: PBM: $2/$10/20%/50%; Mail Order: $6/$30/20%/50% (w/ contra.)",null,null,"$10","20%/50%","$30","20%/50%","20%","50%","20%","50%","Combined (Refer to Medical OOP)","$2","$6","-","RX30CA90","Rx: PBM: $10/20%; Mail Order: $10/20% (w/ contra.)",null,null,"$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"51+ Plan Options",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X501",null,null,null,null,null,"C3X501_7_1_2009","PREMIER OPTION C","$50/$150 Deductible","80%","80%","50%","$1,000","N/A","N/A","N/A","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4A_7_1_2009","Direct Option 4",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1510","2-001155-1510","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","50%","($10,000)",null,null,null,"RX515502XC90","RX_2_10_20_50%_3X","Rx: PBM: $2/$10/$20/50%; Mail Order: $6/$30/$60/50% (w/ contra.)",null,null,"$10","$20/50%","$30","$60/50%","$20","50%","$60","50%","Combined (Refer to Medical OOP)","$2","$6","-","RX35CA90","Rx: PBM: $15/20%; Mail Order: $15/20% (w/ contra.)",null,null,"$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X501",null,null,null,null,null,"D3X501_7_1_2012","PREMIER OPTION D","$50/$150 Deductible (waived on Preventive)","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A","$25 Copay","$200 Copay","$90/$200/$275",120,200,200,120,"$150 Copay",20,"DO5C_7_1_2012","Direct Option 5",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001155-1510","2-001155-1510","Oregon - PPO","No Copay","$1,500 Ded","10%","($5,500)","$1,500 Ded","50%","($10,000)",null,null,null,"RX60C90","RX_2_10_25_50%_3X","Rx: PBM: $2/$10/$25/50%; Mail Order: $6/$30/$75/50% (w/ contra.)",null,null,"$10","$25/50%","$30","$75/50%","$25","50%","$75","50%","Combined (Refer to Medical OOP)","$2","$6","-","RX515502XC90","Rx: PBM: $5/$15/50%; Mail Order: $10/$30/50% (w/ contra.)",null,null,"$5","$15/50%","$10","$30/50%","$15","50%","$30","50%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"11 Digit","Plan","OV COPAY","DED","COINS","HOSP COINS","OOP","DED","COINS","OOP",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E01",null,null,null,null,null,"D3X501_7_1_2009","PREMIER OPTION D","$50/$150 Deductible (waived on Preventive)","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A","$20 Copay","$200 Copay","$75/$150/$225",120,200,200,90,"$150 Copay",20,"DO5A_7_1_2009","Direct Option 5",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1300","2-001163-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","30%","No OOP Max",null,null,null,"RX70C90","RX_2_10_25_50_3X","Rx: PBM: $2/$10/$25/$50; Mail Order: $6/$30/$75/$150 (w/ contra.)",null,null,"$10","$25/$50","$30","$75/$150","$25","$50","$75","$150","Combined (Refer to Medical OOP)","$2","$6","-","RX60C90","Rx: PBM: 40%; Mail Order: 40% (w/ contra.)",null,null,"40%","40%","40%","40%","40%","40%","40%","40%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-002202-0000",null,"1-002202-0000",null,"1-002202-0000","Indemnity","-","$250","20%","20%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E01_7_1_2012","PREMIER OPTION E ","$0","50%","50%","50%","$1,000","N/A","N/A","N/A","$30 Copay","$300 Copay","$150/$300/$400",200,400,500,250,"$190 Copay",25,"DO6C_7_1_2012","Direct Option 6",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1300","2-001163-1300","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","30%","No OOP Max",null,null,null,"","RX_2_10_30_50_3X","Rx: PBM: $2/$10/$30/$50; Mail Order: $6/$30/$90/$150 (w/ contra.)",null,null,"$10","$30/$50","$30","$90/$150","$30","$50","$90","$150","Combined (Refer to Medical OOP)","$2","$6","-","RX70C90","Rx: PBM: 30%; Mail Order: 30% (w/ contra.)",null,null,"30%","30%","30%","30%","30%","30%","30%","30%","N/A"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-002203-0000",null,"1-002203-0000",null,"1-002203-0000","Indemnity","-","$250","20%","20%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E01_7_1_2009","PREMIER OPTION E ","$0","50%","50%","50%","$1,000","N/A","N/A","N/A","$25 Copay","$300 Copay","$150/$250/$350",100,400,500,250,"$190 Copay",25,"DO6A_7_1_2009","Direct Option 6",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1312","2-001163-1312","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","30%","($12,000)",null,null,null,null,"RX_2_10_35_50_3X","Rx: PBM: $2/$10/$35/$50; Mail Order: $6/$30/$105/$150 (w/ contra.)",null,null,"$10","$35/$50","$30","$105/$150","$35","$50","$105","$150","Combined (Refer to Medical OOP)","$2","$6","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-002205-0000",null,"1-002205-0000",null,"1-002205-0000","Indemnity","-","$250","20%","20%","$5,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"F0_7_1_2012","PREMIER OPTION FORTIFY","$0","100%","10%","10%","$500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1312","2-001163-1312","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","30%","($12,000)",null,null,"<<< $2 Value Tier Plans 2X>>>","RX21030502XC90","RX_2_10_40_60_3X","Rx: PBM: $2/$10/$40/$60; Mail Order: $6/$30/$120/$180 (w/ contra.)",null,null,"$10","$40/$60","$30","$120/$180","$40","$60","$120","$180","Combined (Refer to Medical OOP)","$2","$6","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-005203-0000",null,"1-005203-0000",null,"1-005203-0000","Indemnity","-","$500","20%","20%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VA0_7_1_2012","VOLUNTARY PREMIER OPTION B","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1312","2-001163-1312","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","30%","($12,000)",null,null,null,"RX21035502XC90","RX_2_15_25_50%_3X","Rx: PBM: $2/$15/$25/50%; Mail Order: $6/$45/$75/50% (w/ contra.)",null,null,"$15","$25/50%","$45","$75/50%","$25","50%","$75","50%","Combined (Refer to Medical OOP)","$2","$6","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-005205-0000",null,"1-005205-0000",null,"1-005205-0000","Indemnity","-","$500","20%","20%","$5,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VA01_7_1_2012","VOLUNTARY PREMIER OPTION B","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1400","2-001163-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX21040602XC90","RX_2_15_25_50_3X","Rx: PBM: $2/$15/$25/$50; Mail Order: $6/$45/$75/$150 (w/ contra.)",null,null,"$15","$25/$50","$45","$75/$150","$25","$50","$75","$150","Combined (Refer to Medical OOP)","$2","$6","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-008203-0000",null,"1-008203-0000",null,"1-008203-0000","Indemnity","-","$2,500","20%","20%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VB3X50_7_1_2012","VOLUNTARY PREMIER OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1400","2-001163-1400","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX21535502XC90","RX_2_15_35_50_3X","Rx: PBM: $2/$15/$35/$50; Mail Order: $6/$45/$105/$150 (w/ contra.)",null,null,"$15","$35/$50","$45","$105/$150","$35","$50","$105","$150","Combined (Refer to Medical OOP)","$2","$6","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-008205-0000",null,"1-008205-0000",null,"1-008205-0000","Indemnity","-","$2,500","20%","20%","$5,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VB3X501_7_1_2012","VOLUNTARY PREMIER OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1412","2-001163-1412","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","40%","($12,000)",null,null,null,"RX21020%502XC90","RX_2_15_45_75_3X","Rx: PBM: $2/$15/$45/$75; Mail Order: $6/$45/$135/$225 (w/ contra.)",null,null,"$15","$45/$75","$45","$135/$225","$45","$75","$135","$225","Combined (Refer to Medical OOP)","$2","$6","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-009203-0000",null,"1-009203-0000",null,"1-009203-0000","Indemnity","-","$1,000","20%","20%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VBP3X50_7_1_2012","VOLUNTARY PPO OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%","60%",0.5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1412","2-001163-1412","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","40%","($12,000)",null,null,null,"RX21020502XC90","RX_250D_15DW_25_50%_3X","Rx: PBM: $250 Ded, $15 (Ded waived for Value/Generics)/$25/50% , 3x Mail Order Copay",null,null,"$15 (Ded wvd)","$25/50%","$45 (Ded wvd)","$75/50%","$25","50%","$75","50%","Combined (Refer to Medical OOP)","-","-","$250Ded (wvd value/gen)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1-009205-0000",null,"1-009205-0000",null,"1-009205-0000","Indemnity","-","$1,000","20%","20%","$5,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VBP3X501_7_1_2012","VOLUNTARY PPO OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%","60%",0.5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1412","2-001163-1412","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","40%","($12,000)",null,null,null,"RX21025$502XC90","RX_250D_2_15DW_25_50%_3X","Rx: PBM: $250 Ded, $2/$15 (Ded waived for Value/Generics)/$25/50% , 3x Mail Order Copay",null,null,"$15 (Ded wvd)","$25/50%","$45 (Ded wvd)","$75/50%","$25","50%","$75","50%","Combined (Refer to Medical OOP)","$2 (Ded wvd)","$6 (Ded wvd)","$250Ded (wvd value/gen)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-002101-2302",null,"2-002101-2302",null,"2-002101-2302","PPO","-","$250","10%","10%","$1,000","$250","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VC3X50_7_1_2012","VOLUNTARY PREMIER OPTION C","$50/$150","80%","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1500","2-001163-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX21025502XC90","RX_5_15_50%_3X","Rx: PBM: $5/$15/50%; Mail Order: $10/$30/50% (w/ contra.)",null,null,"$5","$15/50%","$15","$45/50%","$15","50%","$45","50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-002101-2303",null,"2-002101-2303",null,"2-002101-2303","PPO","-","$250","10%","10%","$1,000","$250","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VC3X501_7_1_2012","VOLUNTARY PREMIER OPTION C","$50/$150","80%","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-001163-1500","2-001163-1500","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX21525$502XC90","RX1020%502XC90","Rx: PBM: $10/20%/50%; Mail Order: $20/20%/50% (w/ contra.)",null,null,"$10","20%/50%","$20","20%/50%","20%","50%","20%","50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-002202-2404",null,"2-002202-2404",null,"2-002202-2404","PPO","-","$250","20%","20%","$2,000","$250","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VDO1F","VOLUNTARY DIRECT OPTION 1",null,null,null,null,null,null,null,null,"$15 Copay","$375 Copay","$125/$200/$250",100,175,500,500,"$175 Copay",20,"VDO1b",null,"A0_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A",null,"A0_7_1_2009",{"$f":"CZ99&\"_PF\"","v":"A0_7_1_2009_PF"},{"$f":"DA99&\"_PF\"","v":"PREMIER OPTION A _PF"},null,null,null,"_7_1_2009",null,null,{"$f":"CZ99&DQ99","v":"A0_7_1_2009_7_1_2009"},null,null,null,null,null,null,null,"2-001163-1512","2-001163-1512","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","50%","($12,000)",null,null,null,"RX21525502XC90","RX1020502XC90","Rx: PBM: $10/$20/50%; Mail Order: $20/$40/50% (w/ contra.)",null,null,"$10","$20/50%","$20","$40/50%","$20","50%","$40","50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-002202-2406",null,"2-002202-2406",null,"2-002202-2406","PPO","-","$250","20%","20%","$2,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VDO2F","VOLUNTARY DIRECT OPTION 2",null,null,null,null,null,null,null,null,"$25 Copay","$375 Copay","$125/$200/$250",100,175,500,500,"$175 Copay",20,"VDO2b",null,"A0 (Modified)_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","70%/80%/90%/100%","$1,500","N/A","N/A","N/A",null,"A0 (Modified)_7_1_2009",{"$f":"CZ100&\"_PF\"","v":"A0 (Modified)_7_1_2009_PF"},"PREMIER OPTION A _PF",null,null,null,"_7_1_2009",null,null,{"$f":"CZ100&DQ100","v":"A0 (Modified)_7_1_2009_7_1_2009"},null,null,null,null,null,null,null,"2-001163-1512","2-001163-1512","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","50%","($12,000)",null,null,null,"RX250D215DW25502XC90","RX1025$502XC90","Rx: PBM: $10/$25/$50; Mail Order: $20/$50/$100 (w/ contra.)",null,null,"$10","$25/$50","$20","$50/$100","$25","$50","$50","$100","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-005202-5404",null,"2-005202-5404",null,"2-005202-5404","PPO","-","$500","20%","20%","$2,000","$500","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"OUT-CLASS1","OUT-CLASS2","OUT-CLASS3",null,null,null,null,null,null,null,null,null,null,null,"A0 (Modified)_PF_7_1_2009","PREMIER OPTION A _PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","70%/80%/90%/100%","$1,500","N/A","N/A","N/A",null,"A01_7_1_2009","A0 (Modified)_PF_7_1_2009_PF","PREMIER OPTION A _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"A0 (Modified)_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001163-1512","2-001163-1512","Oregon - PPO","No Copay","$1,500 Ded","10%","($6,350)","$1,500 Ded","50%","($12,000)",null,null,null,"","RX1025502XC90","Rx: PBM: $10/$25/50%; Mail Order: $20/$50/50% (w/ contra.)",null,null,"$10","$25/50%","$20","$50/50%","$25","50%","$50","50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-005202-5406",null,"2-005202-5406",null,"2-005202-5406","PPO","-","$500","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A0","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"A0_PF_7_1_2009","PREMIER OPTION A _PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A",null,"A02_7_1_2009","A0_PF_7_1_2009_PF","PREMIER OPTION A _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"A0_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1300","2-001204-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","30%","No OOP Max",null,null,null,null,"RX1030502XC90","Rx: PBM: $10/$30/$50; Mail Order: $20/$60/$100 (w/ contra.)",null,null,"$10","$30/$50","$20","$60/$100","$30","$50","$60","$100","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008205-8410",null,"2-008205-8410",null,"2-008205-8410","PPO","-",2500,0.2,0.2,"$5,000",2500,0.4,10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A0 (Modified)","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","70%/80%/90%/100%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"A01_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,000","N/A","N/A","N/A",null,"A025_7_1_2009","A01_7_1_2009_PF","PREMIER OPTION A _PF",null,null,null,"_7_1_2009",null,null,"A01_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1365","2-001204-1365","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","30%","($6,500)",null,null,"<<< 3X Mail Order >>>","RX_10_20%_50%_3X","RX1035502XC90","Rx: PBM: $10/$35/$50; Mail Order: $20/$70/$100 (w/ contra.)",null,null,"$10","$35/$50","$20","$70/$100","$35","$50","$70","$100","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008205-8415",null,"2-008205-8415",null,"2-008205-8415","PPO","-",2500,0.2,0.2,"$5,000",2500,0.4,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A01","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"A01_PF_7_1_2009","PREMIER OPTION A _PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,000","N/A","N/A","N/A",null,"AP0_7_1_2009","A01_PF_7_1_2009_PF","PREMIER OPTION A _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"A01_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1365","2-001204-1365","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","30%","($6,500)",null,null,null,"RX_10_20_50%_3X","RX1040602XC90","Rx: PBM: $10/$40/$60; Mail Order: $20/$80/$120 (w/ contra.)",null,null,"$10","$40/$60","$20","$80/$120","$40","$60","$80","$120","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008305-8510",null,"2-008305-8510",null,"2-008305-8510","PPO","-",2500,"30%","30%","$5,000",2500,"50%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A02","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"A02_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,000","N/A","N/A","N/A",null,"AP02_7_1_2009","A02_7_1_2009_PF","PREMIER OPTION A _PF",null,null,null,"_7_1_2009",null,null,"A02_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1400","2-001204-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX_10_25_50_3X","RX1525$502XC90","Rx: PBM: $15/$25/$50; Mail Order: $30/$50/$100 (w/ contra.)",null,null,"$15","$25/$50","$30","$50/$100","$25","$50","$50","$100","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008305-8515",null,"2-008305-8515",null,"2-008305-8515","PPO","-",2500,"30%","30%","$5,000",2500,"50%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A025","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"A02_PF_7_1_2009","PREMIER OPTION A _PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,000","N/A","N/A","N/A",null,"AP025_7_1_2009","A02_PF_7_1_2009_PF","PREMIER OPTION A _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"A02_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1465","2-001204-1465","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","40%","($6,500)",null,null,null,"RX_10_25_50%_3X","RX1525502XC90","Rx: PBM: $15/$25/50%; Mail Order: $30/$50/50% (w/ contra.)",null,null,"$15","$25/50%","$30","$50/50%","$25","50%","$50","50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009205-9410",null,"2-009205-9410",null,"2-009205-9410","PPO","-","$1,000",0.2,0.2,"$5,000","$1,000",0.4,10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"AP0","PPO OPTION A","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,null,null,null,null,null,null,null,null,null,null,"A025_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,500","N/A","N/A","N/A",null,"B25_7_1_2009","A025_7_1_2009_PF","PREMIER OPTION A _PF",null,null,null,"_7_1_2009",null,null,"A025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1465","2-001204-1465","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","40%","($6,500)",null,null,null,"RX_10_30_50_3X","RX15502XC90","Rx: PBM $15 or 50% (whichever's greater) w/ $30 or 50% (whichever's greater) Mail Order",null,null,"$15/50%","$15/50%","$30/50%","$30/50%","$15/50%","$15/50%","$30/50%","$30/50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009205-9415",null,"2-009205-9415",null,"2-009205-9415","PPO","-","$1,000",0.2,0.2,"$5,000","$1,000",0.4,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"AP02","PPO OPTION A","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,000","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,null,null,null,null,null,null,null,null,null,null,"A025_PF_7_1_2009","PREMIER OPTION A _PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,500","N/A","N/A","N/A",null,"B251_7_1_2009","A025_PF_7_1_2009_PF","PREMIER OPTION A _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"A025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1500","2-001204-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX_10_35_50_3X","RX21020%502XC90","Rx: PBM: $2/$10/20%/50%; Mail Order: $4/$20/20%/50% (w/ contra.)",null,null,"$10","20%/50%","$20","20%/50%","20%","50%","20%","50%","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009305-9510",null,"2-009305-9510",null,"2-009305-9510","PPO","-","$1,000","30%","30%","$5,000","$1,000","50%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"AP025","PPO OPTION A","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,500","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,null,null,null,null,null,null,null,null,null,null,"AP0_7_1_2009","PPO OPTION A","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,"B252_7_1_2009","AP0_7_1_2009_PF","PPO OPTION A_PF",null,null,null,"_7_1_2009",null,null,"AP0_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1565","2-001204-1565","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","50%","($6,500)",null,null,null,"RX_10_40_60_3X","RX21020502XC90","Rx: PBM: $2/$10/$20/50%; Mail Order: $4/$20/$40/50% (w/ contra.)",null,null,"$10","$20/50%","$20","$40/50%","$20","50%","$40","50%","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009305-9515",null,"2-009305-9515",null,"2-009305-9515","PPO","-","$1,000","30%","30%","$5,000","$1,000","50%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B25","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"AP0_PF_7_1_2009","PPO OPTION A_PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,"B2525_7_1_2009","AP0_PF_7_1_2009_PF","PPO OPTION A_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"AP0_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001204-1565","2-001204-1565","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,000)","$1,500 Ded","50%","($6,500)",null,null,null,"RX_15_25_50_3X","RX21025$502XC90","Rx: PBM: $2/$10/$25/$50; Mail Order: $4/$20/$50/$100 (w/ contra.)",null,null,"$10","$25/$50","$20","$50/$100","$25","$50","$50","$100","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00D310-D530",null,"2-00D310-D530",null,"2-00D310-D530","PPO","-",5000,"30%","30%",10000,5000,"50%",30000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B251","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"AP02_7_1_2009","PPO OPTION A","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,000","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,"B3X25_7_1_2009","AP02_7_1_2009_PF","PPO OPTION A_PF",null,null,null,"_7_1_2009",null,null,"AP02_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1300","2-001205-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","30%","No OOP Max",null,null,null,"RX_15_25_50%_3X","RX21025502XC90","Rx: PBM: $2/$10/$25/50%; Mail Order: $4/$20/$50/50% (w/ contra.)",null,null,"$10","$25/50%","$20","$50/50%","$25","50%","$50","50%","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100101-2302",null,"2-100101-2302",null,"2-100101-2302","PPO","$10","$0","10%","10%","$1,000","$250","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B252","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"AP02_PF_7_1_2009","PPO OPTION A_PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,000","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,"B3X251_7_1_2009","AP02_PF_7_1_2009_PF","PPO OPTION A_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"AP02_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1300","2-001205-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","30%","No OOP Max",null,null,null,"RX_15_50%_3X","RX21030502XC90","Rx: PBM: $2/$10/$30/$50; Mail Order: $4/$20/$60/$100 (w/ contra.)",null,null,"$10","$30/$50","$20","$60/$100","$30","$50","$60","$100","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100101-2303",null,"2-100101-2303",null,"2-100101-2303","PPO","$10","$0","10%","10%","$1,000","$250","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B2525","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"AP025_7_1_2009","PPO OPTION A","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,500","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,"B3X252_7_1_2009","AP025_7_1_2009_PF","PPO OPTION A_PF",null,null,null,"_7_1_2009",null,null,"AP025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1309","2-001205-1309","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","30%","($9,000)",null,null,null,"RX_250D_15DW_25_50%_3X","RX21035502XC90","Rx: PBM: $2/$10/$35/$50; Mail Order: $4/$20/$70/$100 (w/ contra.)",null,null,"$10","$35/$50","$20","$70/$100","$35","$50","$70","$100","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100101-5302",null,"2-100101-5302",null,"2-100101-5302","PPO","$10","$0","10%","10%","$1,000","$500","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X25","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"AP025_PF_7_1_2009","PPO OPTION A_PREV FIRST","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$2,500","50%/60%/70%/80%","50%/60%/70%/80%","50%",null,"B3X2525_7_1_2009","AP025_PF_7_1_2009_PF","PPO OPTION A_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"AP025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1309","2-001205-1309","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","30%","($9,000)",null,null,null,"RX_5_15_50%_3X","RX21040602XC90","Rx: PBM: $2/$10/$40/$60; Mail Order: $4/$20/$80/$120 (w/ contra.)",null,null,"$10","$40/$60","$20","$80/$120","$40","$60","$80","$120","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100101-5303",null,"2-100101-5303",null,"2-100101-5303","PPO","$10","$0","10%","10%","$1,000","$500","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X251","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B25_7_1_2009","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"B3X50_7_1_2009","B25_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1310","2-001205-1310","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","30%","($10,000)",null,null,null,"","RX21525$502XC90","Rx: PBM: $2/$15/$25/$50; Mail Order: $4/$30/$50/$100 (w/ contra.)",null,null,"$15","$25/$50","$30","$50/$100","$25","$50","$50","$100","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100102-2304",null,"2-100102-2304",null,"2-100102-2304","PPO","$10","$0","10%","10%","$2,000","$250","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X252","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B25_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"B3X501_7_1_2009","B25_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1315","2-001205-1315","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","30%","($15,000)",null,null,null,"RX_2_10_30_50_3X","RX21525502XC90","Rx: PBM: $2/$15/$25/50%; Mail Order: $4/$30/$50/50% (w/ contra.)",null,null,"$15","$25/50%","$30","$50/50%","$25","50%","$50","50%","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100102-2306",null,"2-100102-2306",null,"2-100102-2306","PPO","$10","$0","10%","10%","$2,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X2525","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B251_7_1_2009","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"B3X502_7_1_2009","B251_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1400","2-001205-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX_2_10_35_50_3X","RX21535502XC90","Rx: PBM: $2/$15/$35/$50; Mail Order: $4/$30/$70/$100 (w/ contra.)",null,null,"$15","$35/$50","$30","$70/$100","$35","$50","$70","$100","Combined (Refer to Medical OOP)","$2","$4","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100102-5304",null,"2-100102-5304",null,"2-100102-5304","PPO","$10","$0","10%","10%","$2,000","$500","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X50","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B251_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"B3X5025_7_1_2009","B251_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1400","2-001205-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","No OOP Max",null,null,null,"RX_2_10_40_60_3X","RX250D15DW25502XC90","Rx: PBM: $250 Ded, $15 (Ded waived for Value/Generics)/$25/50% , 2x Mail Order Copay",null,null,"$15 (Ded wvd)","$25/50%","$30 (Ded wvd)","$50/50%","$25","50%","$50","50%","Combined (Refer to Medical OOP)","-","-","$250Ded (wvd value/gen)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100102-5306",null,"2-100102-5306",null,"2-100102-5306","PPO","$10","$0","10%","10%","$2,000","$500","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X501","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B252_7_1_2009","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"B50_7_1_2009","B252_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1409","2-001205-1409","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","($9,000)",null,null,null,"RX_2_15_35_50_3X","RX250D215DW25502XC90","Rx: PBM: $250 Ded, $2/$15 (Ded waived for Value/Generics)/$25/50% , 2x Mail Order Copay",null,null,"$15 (Ded wvd)","$25/50%","$30 (Ded wvd)","$50/50%","$25","50%","$50","50%","Combined (Refer to Medical OOP)","$2 (Ded wvd)","$4 (Ded wvd)","$250Ded (wvd value/gen)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100202-2404",null,"2-100202-2404",null,"2-100202-2404","PPO","$10","$0","20%","20%","$2,000","$250","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X502","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B252_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"B501_7_1_2009","B252_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1409","2-001205-1409","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","($9,000)",null,null,null,"RX_2_15_45_75_3X","RX25CA90","Rx: PBM: $5/20%; Mail Order: $5/20% (w/ contra.)",null,null,"$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","$5/20%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100202-2406",null,"2-100202-2406",null,"2-100202-2406","PPO","$10","$0","20%","20%","$2,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X5025","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B2525_7_1_2009","PREMIER OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"B502_7_1_2009","B2525_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1410","2-001205-1410","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","($10,000)",null,null,null,"RX_2_10_20%_50%_3X","RX30CA90","Rx: PBM: $10/20%; Mail Order: $10/20% (w/ contra.)",null,null,"$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","$10/20%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100202-5404",null,"2-100202-5404",null,"2-100202-5404","PPO","$10","$0","20%","20%","$2,000","$500","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B50","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B2525_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"B5025_7_1_2009","B2525_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1415","2-001205-1415","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","($15,000)",null,null,null,"RX_2_10_20_50%_3X","RX35CA90","Rx: PBM: $15/20%; Mail Order: $15/20% (w/ contra.)",null,null,"$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","$15/20%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100202-5406",null,"2-100202-5406",null,"2-100202-5406","PPO","$10","$0","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B501","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B3X25_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"BP25_7_1_2009","B3X25_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1500","2-001205-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX_2_10_25_50_3X","RX515502XC90","Rx: PBM: $5/$15/50%; Mail Order: $10/$30/50% (w/ contra.)",null,null,"$5","$15/50%","$10","$30/50%","$15","50%","$30","50%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100701-2302",null,"2-100701-2302",null,"2-100701-2302","PPO","$10","$0","10%","$100/Day (5)","$1,000","$250","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B502","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B3X25_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"BP251_7_1_2009","B3X25_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1500","2-001205-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","No OOP Max",null,null,null,"RX_2_10_25_50%_3X","RX60C90","Rx: PBM: 40%; Mail Order: 40% (w/ contra.)",null,null,"40%","40%","40%","40%","40%","40%","40%","40%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100701-2303",null,"2-100701-2303",null,"2-100701-2303","PPO","$10","$0","10%","$100/Day (5)","$1,000","$250","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B5025","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B3X251_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"BP252_7_1_2009","B3X251_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1509","2-001205-1509","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","($9,000)",null,null,null,"RX_2_15_25_50_3X","RX70C90","Rx: PBM: 30%; Mail Order: 30% (w/ contra.)",null,null,"30%","30%","30%","30%","30%","30%","30%","30%","Combined (Refer to Medical OOP)","-","-","-"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100701-5302",null,"2-100701-5302",null,"2-100701-5302","PPO","$10","$0","10%","$100/Day (5)","$1,000","$500","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP25","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X251_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"BP2525_7_1_2009","B3X251_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1509","2-001205-1509","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","($9,000)",null,null,null,"RX_2_15_25_50%_3X"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-100701-5303",null,"2-100701-5303",null,"2-100701-5303","PPO","$10","$0","10%","$100/Day (5)","$1,000","$500","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP251","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X252_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"BP3X25_7_1_2009","B3X252_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1510","2-001205-1510","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","($10,000)",null,null,null,"RX_250D_2_15DW_25_50%_3X",null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150101-2302",null,"2-150101-2302",null,"2-150101-2302","PPO","$15","$0","10%","10%","$1,000","$250","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP252","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X252_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"BP3X251_7_1_2009","B3X252_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001205-1515","2-001205-1515","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150101-2303",null,"2-150101-2303",null,"2-150101-2303","PPO","$15","$0","10%","10%","$1,000","$250","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP2525","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X2525_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"BP3X252_7_1_2009","B3X2525_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1300","2-001206-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150101-5302",null,"2-150101-5302",null,"2-150101-5302","PPO","$15","$0","10%","10%","$1,000","$500","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X25","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X2525_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"BP3X2525_7_1_2009","B3X2525_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1313","2-001206-1313","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","30%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150101-5303",null,"2-150101-5303",null,"2-150101-5303","PPO","$15","$0","10%","10%","$1,000","$500","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X251","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X50_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"BP3X50_7_1_2009","B3X50_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1313","2-001206-1313","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","30%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150102-2304",null,"2-150102-2304",null,"2-150102-2304","PPO","$15","$0","10%","10%","$2,000","$250","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X252","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X50_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"BP3X501_7_1_2009","B3X50_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X50_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1400","2-001206-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150102-2306",null,"2-150102-2306",null,"2-150102-2306","PPO","$15","$0","10%","10%","$2,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X2525","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X501_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"BP3X502_7_1_2009","B3X501_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1413","2-001206-1413","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","40%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150102-5304",null,"2-150102-5304",null,"2-150102-5304","PPO","$15","$0","10%","10%","$2,000","$500","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X50","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X501_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"BP3X5025_7_1_2009","B3X501_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1413","2-001206-1413","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","40%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150102-5306",null,"2-150102-5306",null,"2-150102-5306","PPO","$15","$0","10%","10%","$2,000","$500","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X501","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X502_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"BP50_7_1_2009","B3X502_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1500","2-001206-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150103-2300",null,"2-150103-2300",null,"2-150103-2300","PPO","$15","$0","10%","10%","$3,000","$250","30%","None",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X502","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X502_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"BP501_7_1_2009","B3X502_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1513","2-001206-1513","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150103-2306",null,"2-150103-2306",null,"2-150103-2306","PPO","$15","$0","10%","10%","$3,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X5025","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X5025_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"BP502_7_1_2009","B3X5025_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"B3X5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001206-1513","2-001206-1513","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150103-2315",null,"2-150103-2315",null,"2-150103-2315","PPO","$15","$0","10%","10%","$3,000","$250","30%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP50","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B3X5025_PF_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"BP5025_7_1_2009","B3X5025_PF_7_1_2009_PF","PREMIER OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B3X5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1300","2-001225-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150103-5306",null,"2-150103-5306",null,"2-150103-5306","PPO","$15","$0","10%","10%","$3,000","$500","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP501","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B50_7_1_2009","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"C25_7_1_2009","B50_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1335","2-001225-1335","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","30%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150103-5309",null,"2-150103-5309",null,"2-150103-5309","PPO","$15","$0","10%","10%","$3,000","$500","30%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP502","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B50_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,"C251_7_1_2009","B50_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B50_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1335","2-001225-1335","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","30%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150202-2404",null,"2-150202-2404",null,"2-150202-2404","PPO","$15","$0","20%","20%","$2,000","$250","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP5025","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. waived)","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"B501_7_1_2009","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"C252_7_1_2009","B501_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1400","2-001225-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150202-2406",null,"2-150202-2406",null,"2-150202-2406","PPO","$15","$0","20%","20%","$2,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C25","PREMIER OPTION C ","$25","80%","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B501_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,"C2525_7_1_2009","B501_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1435","2-001225-1435","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","40%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150202-5404",null,"2-150202-5404",null,"2-150202-5404","PPO","$15","$0","20%","20%","$2,000","$500","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C251","PREMIER OPTION C ","$25","80%","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B502_7_1_2009","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"C3X25_7_1_2009","B502_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1435","2-001225-1435","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","40%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150202-5406",null,"2-150202-5406",null,"2-150202-5406","PPO","$15","$0","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C252","PREMIER OPTION C ","$25","80%","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B502_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A",null,"C3X251_7_1_2009","B502_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1500","2-001225-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150701-2302",null,"2-150701-2302",null,"2-150701-2302","PPO","$15","$0","10%","$100/Day (5)","$1,000","$250","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C2525","PREMIER OPTION C ","$25","80%","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B5025_7_1_2009","PREMIER OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"C3X252_7_1_2009","B5025_7_1_2009_PF","PREMIER OPTION B_PF",null,null,null,"_7_1_2009",null,null,"B5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1535","2-001225-1535","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150701-2303",null,"2-150701-2303",null,"2-150701-2303","PPO","$15","$0","10%","$100/Day (5)","$1,000","$250","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X25","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"B5025_PF_7_1_2009","PREMIER OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$2,500","N/A","N/A","N/A",null,"C3X2525_7_1_2009","B5025_PF_7_1_2009_PF","PREMIER OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"B5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001225-1535","2-001225-1535","Oregon - PPO","No Copay","$1,500 Ded","20%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150701-5302",null,"2-150701-5302",null,"2-150701-5302","PPO","$15","$0","10%","$100/Day (5)","$1,000","$500","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X251","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP25_7_1_2009","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"C3X50_7_1_2009","BP25_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1300","2-001235-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-150701-5303",null,"2-150701-5303",null,"2-150701-5303","PPO","$15","$0","10%","$100/Day (5)","$1,000","$500","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X252","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP25_PF_7_1_2009","PPO OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"C3X501_7_1_2009","BP25_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1355","2-001235-1355","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","30%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152102-2304",null,"2-152102-2304",null,"2-152102-2304","PPO","$15","$250","10%","10%","$2,000","$250","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X2525","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP251_7_1_2009","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"C3X502_7_1_2009","BP251_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1355","2-001235-1355","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","30%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152102-2306",null,"2-152102-2306",null,"2-152102-2306","PPO","$15","$250","10%","10%","$2,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X50","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP251_PF_7_1_2009","PPO OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"C3X5025_7_1_2009","BP251_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1400","2-001235-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152103-2300",null,"2-152103-2300",null,"2-152103-2300","PPO","$15","$250","10%","10%","$3,000","$250","30%","None",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X501","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP252_7_1_2009","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"C50_7_1_2009","BP252_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1455","2-001235-1455","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152103-2306",null,"2-152103-2306",null,"2-152103-2306","PPO","$15","$250","10%","10%","$3,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X502","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP252_PF_7_1_2009","PPO OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"C501_7_1_2009","BP252_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1455","2-001235-1455","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152103-2315",null,"2-152103-2315",null,"2-152103-2315","PPO","$15","$250","10%","10%","$3,000","$250","30%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X5025","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP2525_7_1_2009","PPO OPTION B","$25","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"C502_7_1_2009","BP2525_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1500","2-001235-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152202-2404",null,"2-152202-2404",null,"2-152202-2404","PPO","$15","$250","20%","20%","$2,000","$250","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C50","PREMIER OPTION C ","$50","80%","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP2525_PF_7_1_2009","PPO OPTION B_PREV FIRST","$25","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"C5025_7_1_2009","BP2525_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1555","2-001235-1555","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","50%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152202-2406",null,"2-152202-2406",null,"2-152202-2406","PPO","$15","$250","20%","20%","$2,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C501","PREMIER OPTION C ","$50","80%","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP3X25_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"CP25_7_1_2009","BP3X25_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001235-1555","2-001235-1555","Oregon - PPO","No Copay","$1,500 Ded","20%","($3,500)","$1,500 Ded","50%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152203-2406",null,"2-152203-2406",null,"2-152203-2406","PPO","$15","$250","20%","20%","$3,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C502","PREMIER OPTION C ","$50","80%","80%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP3X25_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"CP251_7_1_2009","BP3X25_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1300","2-001245-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152203-2409",null,"2-152203-2409",null,"2-152203-2409","PPO","$15","$250","20%","20%","$3,000","$250","40%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C5025","PREMIER OPTION C ","$50","80%","80%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP3X251_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"CP252_7_1_2009","BP3X251_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1375","2-001245-1375","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","30%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155202-5404",null,"2-155202-5404",null,"2-155202-5404","PPO","$15","$500","20%","20%","$2,000","$500","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP25","PPO OPTION C","$25","80%","80%","50%","$1,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X251_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"CP2525_7_1_2009","BP3X251_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1375","2-001245-1375","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","30%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155202-5406",null,"2-155202-5406",null,"2-155202-5406","PPO","$15","$500","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP251","PPO OPTION C","$25","80%","80%","50%","$1,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X252_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"CP3X25_7_1_2009","BP3X252_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1400","2-001245-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155203-5406",null,"2-155203-5406",null,"2-155203-5406","PPO","$15","$500","20%","20%","$3,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP252","PPO OPTION C","$25","80%","80%","50%","$2,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X252_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"CP3X251_7_1_2009","BP3X252_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1475","2-001245-1475","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155203-5409",null,"2-155203-5409",null,"2-155203-5409","PPO","$15","$500","20%","20%","$3,000","$500","40%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP2525","PPO OPTION C","$25","80%","80%","50%","$2,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X2525_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"CP3X252_7_1_2009","BP3X2525_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1475","2-001245-1475","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155205-5410",null,"2-155205-5410",null,"2-155205-5410","PPO","$15","$500","20%","20%","$5,000","$500","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X25","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X2525_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"CP3X2525_7_1_2009","BP3X2525_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1500","2-001245-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155205-5415",null,"2-155205-5415",null,"2-155205-5415","PPO","$15","$500","20%","20%","$5,000","$500","40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X251","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X50_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"CP3X50_7_1_2009","BP3X50_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001245-1575","2-001245-1575","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155305-5500",null,"2-155305-5500",null,"2-155305-5500","PPO","$15","$500","30%","30%","$5,000","$500","50%","None",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X252","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X50_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"CP3X501_7_1_2009",{"$f":"CZ164&\"_PF\"","v":"BP3X50_PF_7_1_2009_PF"},"PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,{"$f":"CZ164&DQ164","v":"BP3X50_PF_7_1_2009_7_1_2009"},null,null,null,null,null,null,null,"2-001245-1575","2-001245-1575","Oregon - PPO","No Copay","$1,500 Ded","20%","($4,500)","$1,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155305-5510",null,"2-155305-5510",null,"2-155305-5510","PPO","$15","$500","30%","30%","$5,000","$500","50%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X2525","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X501_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"CP3X502_7_1_2009","BP3X501_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1300","2-001255-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-159205-9410",null,"2-159205-9410",null,"2-159205-9410","PPO","$15","$1,000","20%","20%","$5,000","$1,000","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X50","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X501_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"CP3X5025_7_1_2009","BP3X501_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1310","2-001255-1310","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200102-2304",null,"2-200102-2304",null,"2-200102-2304","PPO","$20","$0","10%","10%","$2,000","$250","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X501","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X502_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"CP50_7_1_2009","BP3X502_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1310","2-001255-1310","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200102-2306",null,"2-200102-2306",null,"2-200102-2306","PPO","$20","$0","10%","10%","$2,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X502","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X502_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"CP501_7_1_2009","BP3X502_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1400","2-001255-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200102-5304",null,"2-200102-5304",null,"2-200102-5304","PPO","$20","$0","10%","10%","$2,000","$500","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X5025","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X5025_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"CP502_7_1_2009","BP3X5025_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"BP3X5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1410","2-001255-1410","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200102-5306",null,"2-200102-5306",null,"2-200102-5306","PPO","$20","$0","10%","10%","$2,000","$500","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP50","PPO OPTION C","$50","80%","80%","50%","$1,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP3X5025_PF_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"CP5025_7_1_2009","BP3X5025_PF_7_1_2009_PF","PPO OPTION B FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP3X5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1410","2-001255-1410","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200202-2404",null,"2-200202-2404",null,"2-200202-2404","PPO","$20","$0","20%","20%","$2,000","$250","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP501","PPO OPTION C","$50","80%","80%","50%","$1,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP50_7_1_2009","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"D25_7_1_2009","BP50_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1500","2-001255-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200202-2406",null,"2-200202-2406",null,"2-200202-2406","PPO","$20","$0","20%","20%","$2,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP502","PPO OPTION C","$50","80%","80%","50%","$2,000","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP50_PF_7_1_2009","PPO OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. wavied)","60%","50%",null,"D251_7_1_2009","BP50_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP50_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1510","2-001255-1510","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200202-5404",null,"2-200202-5404",null,"2-200202-5404","PPO","$20","$0","20%","20%","$2,000","$500","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP5025","PPO OPTION C","$50","80%","80%","50%","$2,500","60%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"BP501_7_1_2009","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"D252_7_1_2009","BP501_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001255-1510","2-001255-1510","Oregon - PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-200202-5406",null,"2-200202-5406",null,"2-200202-5406","PPO","$20","$0","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D25","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP501_PF_7_1_2009","PPO OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. wavied)","60%","50%",null,"D2525_7_1_2009","BP501_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1300","2-001263-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202102-2304",null,"2-202102-2304",null,"2-202102-2304","PPO","$20","$250","10%","10%","$2,000","$250","30%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D251","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP502_7_1_2009","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"D3X25_7_1_2009","BP502_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1300","2-001263-1300","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202102-2306",null,"2-202102-2306",null,"2-202102-2306","PPO","$20","$250","10%","10%","$2,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D252","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP502_PF_7_1_2009","PPO OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$2,000","80%(Ded. wavied)","60%","50%",null,"D3X251_7_1_2009","BP502_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1312","2-001263-1312","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","30%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202103-2306",null,"2-202103-2306",null,"2-202103-2306","PPO","$20","$250","10%","10%","$3,000","$250","30%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D2525","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP5025_7_1_2009","PPO OPTION B","$50","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"D3X252_7_1_2009","BP5025_7_1_2009_PF","PPO OPTION B_PF",null,null,null,"_7_1_2009",null,null,"BP5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1312","2-001263-1312","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","30%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202103-2309",null,"2-202103-2309",null,"2-202103-2309","PPO","$20","$250","10%","10%","$3,000","$250","30%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X25","PREMIER OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"BP5025_PF_7_1_2009","PPO OPTION B_PREV FIRST","$50","100%(Ded. wavied)","80%","50%","$2,500","80%(Ded. wavied)","60%","50%",null,"D3X2525_7_1_2009","BP5025_PF_7_1_2009_PF","PPO OPTION B_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"BP5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1312","2-001263-1312","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","30%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202202-2404",null,"2-202202-2404",null,"2-202202-2404","PPO","$20","$250","20%","20%","$2,000","$250","40%",4000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X251","PREMIER OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C25_7_1_2009","PREMIER OPTION C ","$25","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"D3X50_7_1_2009","C25_7_1_2009_PF","PREMIER OPTION C _PF",null,null,null,"_7_1_2009",null,null,"C25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1400","2-001263-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202202-2406",null,"2-202202-2406",null,"2-202202-2406","PPO","$20","$250","20%","20%","$2,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X252","PREMIER OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C25_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$25","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"D3X501_7_1_2009","C25_PF_7_1_2009_PF","PREMIER OPTION C _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1400","2-001263-1400","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202203-2406",null,"2-202203-2406",null,"2-202203-2406","PPO","$20","$250","20%","20%","$3,000","$250","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X2525","PREMIER OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C251_7_1_2009","PREMIER OPTION C ","$25","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"D3X502_7_1_2009","C251_7_1_2009_PF","PREMIER OPTION C _PF",null,null,null,"_7_1_2009",null,null,"C251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1412","2-001263-1412","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202203-2409",null,"2-202203-2409",null,"2-202203-2409","PPO","$20","$250","20%","20%","$3,000","$250","40%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X50","PREMIER OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C251_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$25","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"D3X5025_7_1_2009","C251_PF_7_1_2009_PF","PREMIER OPTION C _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1412","2-001263-1412","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205202-5404",null,"2-205202-5404",null,"2-205202-5404","PPO","$20","$500","20%","20%","$2,000","$500","40%","$4,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X501","PREMIER OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C252_7_1_2009","PREMIER OPTION C ","$25","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"D50_7_1_2009","C252_7_1_2009_PF","PREMIER OPTION C _PF",null,null,null,"_7_1_2009",null,null,"C252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1412","2-001263-1412","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205202-5406",null,"2-205202-5406",null,"2-205202-5406","PPO","$20","$500","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X502","PREMIER OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C252_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$25","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"D501_7_1_2009","C252_PF_7_1_2009_PF","PREMIER OPTION C _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1500","2-001263-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205202-5406",null,"2-205202-5406",null,"2-205202-5406","PPO","$20","$500","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X5025","PREMIER OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C2525_7_1_2009","PREMIER OPTION C ","$25","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"D502_7_1_2009","C2525_7_1_2009_PF","PREMIER OPTION C _PF",null,null,null,"_7_1_2009",null,null,"C2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1500","2-001263-1500","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205203-5406",null,"2-205203-5406",null,"2-205203-5406","PPO","$20","$500","20%","20%","$3,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D50","PREMIER OPTION D ","$50","80%(Ded. wavied)","50%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C2525_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$25","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"D5025_7_1_2009","C2525_PF_7_1_2009_PF","PREMIER OPTION C _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1512","2-001263-1512","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205203-5409",null,"2-205203-5409",null,"2-205203-5409","PPO","$20","$500","20%","20%","$3,000","$500","40%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D501","PREMIER OPTION D ","$50","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C3X25_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"DP25_7_1_2009","C3X25_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1512","2-001263-1512","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205205-5410",null,"2-205205-5410",null,"2-205205-5410","PPO","$20","$500","20%","20%","$5,000","$500","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D502","PREMIER OPTION D ","$50","80%(Ded. wavied)","50%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C3X25_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"DP251_7_1_2009","C3X25_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001263-1512","2-001263-1512","Oregon - PPO","No Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205205-5415",null,"2-205205-5415",null,"2-205205-5415","PPO","$20","$500","20%","20%","$5,000","$500","40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D5025","PREMIER OPTION D ","$50","80%(Ded. wavied)","50%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C3X251_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"DP252_7_1_2009","C3X251_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001304-1400","2-001304-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205225-5475",null,"2-205225-5475",null,"2-205225-5475","PPO",20,500,0.2,0.2,2500,500,0.4,7500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP25","PPO OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X251_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"DP2525_7_1_2009","C3X251_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001304-1465","2-001304-1465","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,000)","$1,500 Ded","40%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205225-5575",null,"2-205225-5575",null,"2-205225-5575","PPO",20,500,0.2,0.2,2500,500,0.5,7500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP251","PPO OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X252_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"DP3X25_7_1_2009","C3X252_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001304-1465","2-001304-1465","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,000)","$1,500 Ded","40%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205235-5410",null,"2-205235-5410",null,"2-205235-5410","PPO","$20","$500","20%","20%",3500,"$500","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP252","PPO OPTION D","$25","80%(Ded. wavied)","50%","50%","$2,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X252_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"DP3X251_7_1_2009","C3X252_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001304-1500","2-001304-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205305-5500",null,"2-205305-5500",null,"2-205305-5500","PPO","$20","$500","30%","30%","$5,000","$500","50%","None",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP2525","PPO OPTION D","$25","80%(Ded. wavied)","50%","50%","$2,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X2525_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"DP3X252_7_1_2009","C3X2525_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001304-1565","2-001304-1565","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,000)","$1,500 Ded","50%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205305-5510",null,"2-205305-5510",null,"2-205305-5510","PPO","$20","$500","30%","30%","$5,000","$500","50%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X25","PPO OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$1,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X2525_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"DP3X2525_7_1_2009","C3X2525_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001304-1565","2-001304-1565","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,000)","$1,500 Ded","50%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-209205-9410",null,"2-209205-9410",null,"2-209205-9410","PPO","$20","$1,000","20%","20%","$5,000","$1,000","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X251","PPO OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$1,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X50_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"DP3X50_7_1_2009","C3X50_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1400","2-001305-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-209205-9415",null,"2-209205-9415",null,"2-209205-9415","PPO","$20","$1,000","20%","20%","$5,000","$1,000","40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X252","PPO OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$2,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X50_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"DP3X501_7_1_2009","C3X50_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X50_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1400","2-001305-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251205-1410",null,"2-251205-1410",null,"2-251205-1410","PPO","$25",1500,"20%","20%","$5,000",1500,"40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X2525","PPO OPTION D FAMILY DEDUCTIBLE","$25/$75","80%(Ded. wavied)","50%","50%","$2,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X501_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"DP3X502_7_1_2009","C3X501_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1409","2-001305-1409","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251205-1515",null,"2-251205-1515",null,"2-251205-1515","PPO","$25",1500,"20%","20%","$5,000",1500,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X50","PPO OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$1,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X501_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"DP3X5025_7_1_2009","C3X501_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1409","2-001305-1409","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251603-1506",null,"2-251603-1506",null,"2-251603-1506","PPO",25,1500,0.25,0.25,3000,1500,0.5,6000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X501","PPO OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$1,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X502_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"DP50_7_1_2009","C3X502_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1410","2-001305-1410","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251635-1507",null,"2-251635-1507",null,"2-251635-1507","PPO",25,1500,0.25,0.25,3500,1500,0.5,7000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X502","PPO OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$2,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X502_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"DP501_7_1_2009","C3X502_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1415","2-001305-1415","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251635-1513",null,"2-251635-1513",null,"2-251635-1513","PPO",25,1500,0.25,0.25,3500,1500,0.5,10500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP3X5025","PPO OPTION D FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","50%","50%","$2,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X5025_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"DP502_7_1_2009","C3X5025_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PF",null,null,null,"_7_1_2009",null,null,"C3X5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1500","2-001305-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255205-5410",null,"2-255205-5410",null,"2-255205-5410","PPO","$25","$500","20%","20%","$5,000","$500","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP50","PPO OPTION D","$50","80%(Ded. wavied)","50%","50%","$1,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C3X5025_PF_7_1_2009","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"DP5025_7_1_2009","C3X5025_PF_7_1_2009_PF","PREMIER OPTION C FAMILY DEDUCTIBLE_PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C3X5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1500","2-001305-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255205-5415",null,"2-255205-5415",null,"2-255205-5415","PPO","$25","$500","20%","20%","$5,000","$500","40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP501","PPO OPTION D","$50","80%(Ded. wavied)","50%","50%","$1,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C50_7_1_2009","PREMIER OPTION C ","$50","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"E0_7_1_2009","C50_7_1_2009_PF","PREMIER OPTION C _PF",null,null,null,"_7_1_2009",null,null,"C50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1509","2-001305-1509","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255305-5500",null,"2-255305-5500",null,"2-255305-5500","PPO","$25","$500","30%","30%","$5,000","$500","50%","None",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP502","PPO OPTION D","$50","80%(Ded. wavied)","50%","50%","$2,000","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C50_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$50","80%","80%","50%","$1,500","N/A","N/A","N/A",null,"E01_7_1_2009","C50_PF_7_1_2009_PF","PREMIER OPTION C _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C50_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1509","2-001305-1509","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255305-5510",null,"2-255305-5510",null,"2-255305-5510","PPO","$25","$500","30%","30%","$5,000","$500","50%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP5025","PPO OPTION D","$50","80%(Ded. wavied)","50%","50%","$2,500","60% Ded. Waived","50%","50%",null,null,null,null,null,null,null,null,null,null,null,"C501_7_1_2009","PREMIER OPTION C ","$50","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"E02_7_1_2009","C501_7_1_2009_PF","PREMIER OPTION C _PF",null,null,null,"_7_1_2009",null,null,"C501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1510","2-001305-1510","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-256635-6513",null,"2-256635-6513",null,"2-256635-6513","PPO",25,2000,0.25,0.25,3500,2000,"50%",10500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E0","PREMIER OPTION E ","$0","50%","50%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C501_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$50","80%","80%","50%","$1,000","N/A","N/A","N/A",null,"E025_7_1_2009","C501_PF_7_1_2009_PF","PREMIER OPTION C _PREV FIRST_PF",null,null,null,"_7_1_2009",null,null,"C501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001305-1515","2-001305-1515","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257203-7406",null,"2-257203-7406",null,"2-257203-7406","PPO","$25",750,"20%","20%","$3,000",750,"40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E01","PREMIER OPTION E ","$0","50%","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C502_7_1_2009","PREMIER OPTION C ","$50","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"W3X50_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"C502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001306-1400","2-001306-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257203-7409",null,"2-257203-7409",null,"2-257203-7409","PPO","$25",750,"20%","20%","$3,000",750,"40%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E02","PREMIER OPTION E ","$0","50%","50%","50%","$2,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C502_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$50","80%","80%","50%","$2,000","N/A","N/A","N/A",null,"W3X501_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"C502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001306-1413","2-001306-1413","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,000)","$1,500 Ded","40%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257203-7509",null,"2-257203-7509",null,"2-257203-7509","PPO","$25",750,"20%","20%","$3,000",750,0.5,"$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E025","PREMIER OPTION E ","$0","50%","50%","50%","$2,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C5025_7_1_2009","PREMIER OPTION C ","$50","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"A0_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"C5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001306-1413","2-001306-1413","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,000)","$1,500 Ded","40%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257204-7408",null,"2-257204-7408",null,"2-257204-7408","PPO","$25",750,"20%","20%",4000,750,"40%",8000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VA0","VOLUNTARY PREMIER OPTION B","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"C5025_PF_7_1_2009","PREMIER OPTION C _PREV FIRST","$50","80%","80%","50%","$2,500","N/A","N/A","N/A",null,"A0 (Modified)_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"C5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001306-1500","2-001306-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,000)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257204-7412",null,"2-257204-7412",null,"2-257204-7412","PPO","$25",750,"20%","20%",4000,750,"40%",12000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VA01","VOLUNTARY PREMIER OPTION B","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"CP25_7_1_2009","PPO OPTION C","$25","80%","80%","50%","$1,500","60%","60%","50%",null,"A01_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001306-1513","2-001306-1513","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,000)","$1,500 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257205-7415",null,"2-257205-7415",null,"2-257205-7415","PPO","$25",750,"20%","20%","$5,000",750,"40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"VB3X50","VOLUNTARY PREMIER OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"CP25_PF_7_1_2009","PPO OPTION C_PREV FIRST","$25","80%","80%","50%","$1,500","60%","60%","50%",null,"A02_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001306-1513","2-001306-1513","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,000)","$1,500 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257225-7475",null,"2-257225-7475",null,"2-257225-7475","PPO","$25",750,"20%","20%",2500,750,"40%",7500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"CB213&BW213","v":"A0 (Modified)_7_1_2012"},null,"A0 (Modified)_7_1_2012",null,null,"VB3X501","VOLUNTARY PREMIER OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"CP251_7_1_2009","PPO OPTION C","$25","80%","80%","50%","$1,000","60%","60%","50%",null,"A025_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001325-1400","2-001325-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257303-7506",null,"2-257303-7506",null,"2-257303-7506","PPO","$25",750,"30%","30%","$3,000",750,0.5,"$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"CB214&BW214","v":"A0 (Modified)_7_1_2009"},null,"A0 (Modified)_7_1_2009",null,null,"VBP3X50","VOLUNTARY PPO OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%","60%","50%",null,null,null,null,null,null,null,null,null,null,null,"CP251_PF_7_1_2009","PPO OPTION C_PREV FIRST","$25","80%","80%","50%","$1,000","60%","60%","50%",null,"AP0_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001325-1435","2-001325-1435","Oregon - PPO","No Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","40%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257303-7509",null,"2-257303-7509",null,"2-257303-7509","PPO","$25",750,"30%","30%","$3,000",750,0.5,"$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A0_1_1_2018",null,"A0_1_1_2018",null,null,"VBP3X501","VOLUNTARY PPO OPTION B","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%","60%","50%",null,null,null,null,null,"2016 Plans","2016 Plans","2016 Plans","2018 Plans","2018 Plans","2018 Plans","CP252_7_1_2009","PPO OPTION C","$25","80%","80%","50%","$2,000","60%","60%","50%",null,"AP02_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001325-1435","2-001325-1435","Oregon - PPO","No Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","40%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257304-7508",null,"2-257304-7508",null,"2-257304-7508","PPO","$25",750,"30%","30%",4000,750,0.5,8000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A0_7_1_2009",null,"A0_7_1_2009",null,null,"VC3X50","VOLUNTARY PREMIER OPTION C","$50/$150","80%","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 1","DO1D_1_1_2016","Direct Option 1","Direct Option 1","DO1F_1_1_2018","Direct Option 1","CP252_PF_7_1_2009","PPO OPTION C_PREV FIRST","$25","80%","80%","50%","$2,000","60%","60%","50%",null,"AP025_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001325-1500","2-001325-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257304-7512",null,"2-257304-7512",null,"2-257304-7512","PPO","$25",750,"30%","30%",4000,750,0.5,12000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X25_1_1_2018",null,"B3X25_1_1_2018",null,null,"VC3X501","VOLUNTARY PREMIER OPTION C","$50/$150","80%","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 2","DO2D_1_1_2016","Direct Option 2","Direct Option 1","DO1F_1_1_2018","Direct Option 1","CP2525_7_1_2009","PPO OPTION C","$25","80%","80%","50%","$2,500","60%","60%","50%",null,"B25_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001325-1535","2-001325-1535","Oregon - PPO","No Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257305-7515",null,"2-257305-7515",null,"2-257305-7515","PPO","$25",750,"30%","30%","$5,000",750,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X25_7_1_2009",null,"B3X25_7_1_2009",null,null,"VDPA","OLD VOLUNTARY PLAN A","$50","100%(Ded.waived)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 3","DO3D_1_1_2016","Direct Option 3","Direct Option 3","DO3F_1_1_2018","Direct Option 3","CP2525_PF_7_1_2009","PPO OPTION C_PREV FIRST","$25","80%","80%","50%","$2,500","60%","60%","50%",null,"B251_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001325-1535","2-001325-1535","Oregon - PPO","No Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-258305-8515",null,"2-258305-8515",null,"2-258305-8515","PPO","$25",2500,"30%","30%","$5,000",2500,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X251_1_1_2018",null,"B3X251_1_1_2018",null,null,"VDPAO","OLD VOLUNTARY PLAN A  W/ORTHO","$50","100%(Ded.waived)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 4","DO4D_1_1_2016","Direct Option 4","Direct Option 4","DO4F_1_1_2018","Direct Option 4","CP3X25_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,500","60%","60%","50%",null,"B252_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001335-1400","2-001335-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-258605-8515",null,"2-258605-8515",null,"2-258605-8515","PPO","$25",2500,0.25,0.25,"$5,000",2500,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X251_7_1_2009",null,"B3X251_7_1_2009",null,null,"VDPB","OLD VOLUNTARY PLAN B","$50","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 5","DO5D_1_1_2016","Direct Option 5","Direct Option 5","DO5F_1_1_2018","Direct Option 5","CP3X25_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$1,500","60%","60%","50%",null,"B2525_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001335-1455","2-001335-1455","Oregon - PPO","No Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259203-9409",null,"2-259203-9409",null,"2-259203-9409","PPO",25,1000,0.2,0.2,3000,1000,0.4,9000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X50_1_1_2018",null,"B3X50_1_1_2018",null,null,"VDPBO","OLD VOLUNTARY PLAN B  W/ORTHO","$50","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 6","DO6D_1_1_2016","Direct Option 6","Direct Option 5","DO5F_1_1_2018","Direct Option 5","CP3X251_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$1,000","60%","60%","50%",null,"B3X25_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001335-1455","2-001335-1455","Oregon - PPO","No Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259203-9509",null,"2-259203-9509",null,"2-259203-9509","PPO",25,1000,0.2,0.2,3000,1000,0.5,9000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X50_7_1_2009",null,"B3X50_7_1_2009",null,null,"VDPC","OLD VOLUNTARY PLAN C","$50","50%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,"Direct Option 8","DO8D_1_1_2016","Direct Option 8","Direct Option 7","DO7F_1_1_2018","Direct Option 7","CP3X251_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$1,000","60%","60%","50%",null,"B3X251_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001335-1500","2-001335-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259204-9408",null,"2-259204-9408",null,"2-259204-9408","PPO","$25","$1,000","20%","20%",4000,"$1,000","40%",8000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X501_1_1_2018",null,"B3X501_1_1_2018",null,null,"VDPCO","OLD VOLUNTARY PLAN C  W/ORTHO","$50","50%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"CP3X252_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,000","60%","60%","50%",null,"B3X252_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001335-1555","2-001335-1555","Oregon - PPO","No Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","50%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259205-9410",null,"2-259205-9410",null,"2-259205-9410","PPO","$25","$1,000","20%","20%","$5,000","$1,000","40%",10000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X501_7_1_2009",null,"B3X501_7_1_2009",null,null,"W3X50","PREMIER OPTION W FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"CP3X252_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$2,000","60%","60%","50%",null,"B3X2525_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001335-1555","2-001335-1555","Oregon - PPO","No Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","50%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259205-9415",null,"2-259205-9415",null,"2-259205-9415","PPO","$25","$1,000","20%","20%","$5,000","$1,000","40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X502_1_1_2018",null,"B3X502_1_1_2018",null,null,"W3X501","PREMIER OPTION W FAMILY DEDUCTIBLE","$50/$150","80%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A",null,null,null,null,null,null,null,null,null,null,null,"CP3X2525_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$25/$75","80%","80%","50%","$2,500","60%","60%","50%",null,"B3X50_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001345-1400","2-001345-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259225-9475",null,"2-259225-9475",null,"2-259225-9475","PPO",25,1000,0.2,0.2,2500,1000,0.4,7500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B3X502_7_1_2009",null,"B3X502_7_1_2009",null,null,"VDO2","VOLUNTARY DIRECT OPTION 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X2525_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$25/$75","80%","80%","50%","$2,500","60%","60%","50%",null,"B3X501_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001345-1475","2-001345-1475","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,500)","$1,500 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-25D605-D515",null,"2-25D605-D515",null,"2-25D605-D515","PPO","$25",5000,0.25,0.25,"$5,000",5000,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X25_1_1_2018",null,"BP3X25_1_1_2018",null,null,"VDO2","VOLUNTARY DIRECT OPTION 2",null,null,null,null,null,"OUT-CLASS1","OUT-CLASS2","OUT-CLASS3",null,null,null,null,null,null,null,null,null,null,null,"CP3X50_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,500","60%","60%","50%",null,"B3X502_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001345-1475","2-001345-1475","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,500)","$1,500 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301303-1509",null,"2-301303-1509",null,"2-301303-1509","PPO","$30",1500,0.3,0.3,3000,3000,0.5,9000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X25_7_1_2009",null,"BP3X25_7_1_2009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X50_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$1,500","60%","60%","50%",null,"B3X5025_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,{"$f":"CZ228&DQ228","v":"CP3X50_PF_7_1_2009_7_1_2009"},null,null,null,null,null,null,null,"2-001345-1500","2-001345-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301304-1512",null,"2-301304-1512",null,"2-301304-1512","PPO","$30",1500,0.3,0.3,3000,4000,0.5,12000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X251_1_1_2018",null,"BP3X251_1_1_2018",null,null,"A0 (Modified)_1_1_2018","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","70%/80%/90%/100%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1F_1_1_2018","Direct Option 1","CP3X501_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$1,000","60%","60%","50%",null,"B50_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001345-1575","2-001345-1575","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,500)","$1,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301335-1513",null,"2-301335-1513",null,"2-301335-1513","PPO","$30",1500,0.3,0.3,3000,3500,0.5,10500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X251_7_1_2009",null,"BP3X251_7_1_2009",null,null,"A0 (Modified)_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","70%/80%/90%/100%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","CP3X501_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$1,000","60%","60%","50%",null,"B501_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001345-1575","2-001345-1575","Oregon - PPO","No Copay","$1,500 Ded","30%","($4,500)","$1,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301345-1514",null,"2-301345-1514",null,"2-301345-1514","PPO","$30",1500,0.3,0.3,4500,3500,0.5,13500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X50_1_1_2018",null,"BP3X50_1_1_2018",null,null,"A0_1_1_2018","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1F_1_1_2018","Direct Option 1","CP3X502_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,000","60%","60%","50%",null,"B502_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001355-1400","2-001355-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305202-5406",null,"2-305202-5406",null,"2-305202-5406","PPO","$30","$500","20%","20%","$2,000","$500","40%","$6,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X50_7_1_2009",null,"BP3X50_7_1_2009",null,null,"A0_7_1_2009","PREMIER OPTION A ","$0","70%/80%/90%/100%","70%/80%/90%/100%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","CP3X502_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$2,000","60%","60%","50%",null,"B5025_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001355-1410","2-001355-1410","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,500)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305203-5409",null,"2-305203-5409",null,"2-305203-5409","PPO","$30","$500","20%","20%",3000,"$500","40%",9000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X501_1_1_2018",null,"BP3X501_1_1_2018",null,null,"B3X25_1_1_2018","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1F_1_1_2018","Direct Option 1","CP3X5025_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE","$50/$150","80%","80%","50%","$2,500","60%","60%","50%",null,"BP25_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001355-1410","2-001355-1410","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,500)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305225-5475",null,"2-305225-5475",null,"2-305225-5475","PPO","$30","$500","20%","20%",2500,"$500","40%",7500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X501_7_1_2009",null,"BP3X501_7_1_2009",null,null,"B3X25_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","CP3X5025_PF_7_1_2009","PPO OPTION C FAMILY DEDUCTIBLE_PREV FIRST","$50/$150","80%","80%","50%","$2,500","60%","60%","50%",null,"BP251_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP3X5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001355-1500","2-001355-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305235-5513",null,"2-305235-5513",null,"2-305235-5513","PPO","$30","$500","20%","20%",3500,"$500",50,10500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X25_1_1_2018",null,"C3X25_1_1_2018",null,null,"B3X251_1_1_2018","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3F_1_1_2018","Direct Option 3","CP50_7_1_2009","PPO OPTION C","$50","80%","80%","50%","$1,500","60%","60%","50%",null,"BP252_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP50_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001355-1510","2-001355-1510","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,500)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-306205-6415",null,"2-306205-6415",null,"2-306205-6415","PPO","$30",2000,"20%","20%","$5,000",2000,"40%",15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X25_7_1_2009",null,"C3X25_7_1_2009",null,null,"B3X251_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","CP50_PF_7_1_2009","PPO OPTION C_PREV FIRST","$50","80%","80%","50%","$1,500","60%","60%","50%",null,"BP2525_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP50_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001355-1510","2-001355-1510","Oregon - PPO","No Copay","$1,500 Ded","30%","($5,500)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-306345-6514",null,"2-306345-6514",null,"2-306345-6514","PPO","$30",2000,0.3,0.3,4500,2000,0.5,13500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X50_1_1_2018",null,"C3X50_1_1_2018",null,null,"B3X50_1_1_2018","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1F_1_1_2018","Direct Option 1","CP501_7_1_2009","PPO OPTION C","$50","80%","80%","50%","$1,000","60%","60%","50%",null,"BP3X25_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP501_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1400","2-001363-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307203-7409",null,"2-307203-7409",null,"2-307203-7409","PPO","$30",750,"20%","20%","$3,000",750,"40%","$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X50_7_1_2009",null,"C3X50_7_1_2009",null,null,"B3X50_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","CP501_PF_7_1_2009","PPO OPTION C_PREV FIRST","$50","80%","80%","50%","$1,000","60%","60%","50%",null,"BP3X251_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP501_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1400","2-001363-1400","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307203-7509",null,"2-307203-7509",null,"2-307203-7509","PPO","$30",750,"20%","20%","$3,000",750,0.5,"$9,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X501_1_1_2018",null,"C3X501_1_1_2018",null,null,"B3X501_1_1_2018","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3F_1_1_2018","Direct Option 3","CP502_7_1_2009","PPO OPTION C","$50","80%","80%","50%","$2,000","60%","60%","50%",null,"BP3X252_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP502_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1412","2-001363-1412","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307204-7512",null,"2-307204-7512",null,"2-307204-7512","PPO","$30",750,"20%","20%",4000,750,0.5,12000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"C3X501_7_1_2009",null,"C3X501_7_1_2009",null,null,"B3X501_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","N/A","N/A","N/A","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","CP502_PF_7_1_2009","PPO OPTION C_PREV FIRST","$50","80%","80%","50%","$2,000","60%","60%","50%",null,"BP3X2525_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP502_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1412","2-001363-1412","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307235-7513",null,"2-307235-7513",null,"2-307235-7513","PPO","$30",750,"20%","20%",3500,750,0.5,10500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X50_1_1_2018",null,"CP3X50_1_1_2018",null,null,"B3X502_1_1_2018","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A","$10 Copay","$100 Copay","$50/$90/$140",75,75,75,50,"$75 Copay",20,"DO1F_1_1_2018","Direct Option 1","CP5025_7_1_2009","PPO OPTION C","$50","80%","80%","50%","$2,500","60%","60%","50%",null,"BP3X50_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP5025_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1412","2-001363-1412","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-309203-9409",null,"2-309203-9409",null,"2-309203-9409","PPO","$30",1000,0.2,0.2,3000,1000,0.4,9000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X50_7_1_2009",null,"CP3X50_7_1_2009",null,null,"B3X502_7_1_2009","PREMIER OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$2,000","N/A","N/A","N/A","$10 Copay","$30 Copay","$20/$40/$60",20,20,20,20,"$20 Copay",10,"DO1A_7_1_2009","Direct Option 1","CP5025_PF_7_1_2009","PPO OPTION C_PREV FIRST","$50","80%","80%","50%","$2,500","60%","60%","50%",null,"BP3X501_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"CP5025_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1500","2-001363-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-309203-9509",null,"2-309203-9509",null,"2-309203-9509","PPO","$30",1000,0.2,0.2,3000,1000,0.5,9000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X501_1_1_2018",null,"CP3X501_1_1_2018",null,null,"BP3X25_1_1_2018","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3F_1_1_2018","Direct Option 3","D25_7_1_2009","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,500","N/A","N/A","N/A",null,"BP3X502_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1500","2-001363-1500","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-309204-9512",null,"2-309204-9512",null,"2-309204-9512","PPO","$30",1000,0.2,0.2,4000,1000,0.5,12000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X501_7_1_2009",null,"CP3X501_7_1_2009",null,null,"BP3X25_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","D25_PF_7_1_2009","PREMIER OPTION D_PREV FIRST","$25","80%(Ded. wavied)","50%","50%","$1,500","N/A","N/A","N/A",null,"BP3X5025_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D25_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1512","2-001363-1512","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-309235-9513",null,"2-309235-9513",null,"2-309235-9513","PPO","$30",1000,0.2,0.2,3500,1000,0.5,10500,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X251_1_1_2018",null,"D3X251_1_1_2018",null,null,"BP3X251_1_1_2018","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4F_1_1_2018","Direct Option 4","D251_7_1_2009","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,"BP50_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D251_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1512","2-001363-1512","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-351305-1515",null,"2-351305-1515",null,"2-351305-1515","PPO","$35",1500,0.3,0.3,"$5,000",1500,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X251_7_1_2009",null,"D3X251_7_1_2009",null,null,"BP3X251_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$25/$75","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4A_7_1_2009","Direct Option 4","D251_PF_7_1_2009","PREMIER OPTION D_PREV FIRST","$25","80%(Ded. wavied)","50%","50%","$1,000","N/A","N/A","N/A",null,"BP501_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D251_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001363-1512","2-001363-1512","Oregon - PPO","No Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-356305-6515",null,"2-356305-6515",null,"2-356305-6515","PPO","$35",2000,0.3,0.3,"$5,000",2000,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X50_1_1_2018",null,"D3X50_1_1_2018",null,null,"BP3X50_1_1_2018","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3F_1_1_2018","Direct Option 3","D252_7_1_2009","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$2,000","N/A","N/A","N/A",null,"BP502_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D252_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001604-1300","2-001604-1300","Oregon - PPO","No Copay","$1,500 Ded","25%","($4,000)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-358305-8515",null,"2-358305-8515",null,"2-358305-8515","PPO","$35",2500,0.3,0.3,"$5,000",2500,0.5,15000,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X50_7_1_2009",null,"D3X50_7_1_2009",null,null,"BP3X50_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,500","80%(Ded. waived)","60%","50%","$15 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO3A_7_1_2009","Direct Option 3","D252_PF_7_1_2009","PREMIER OPTION D_PREV FIRST","$25","80%(Ded. wavied)","50%","50%","$2,000","N/A","N/A","N/A",null,"BP5025_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D252_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001604-1365","2-001604-1365","Oregon - PPO","No Copay","$1,500 Ded","25%","($4,000)","$1,500 Ded","30%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3-100101-2302",null,"3-100101-2302",null,"3-100101-2302","Point of Service","$10","$0","10%","10%","$1,000","$250","30%","$2,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X501_1_1_2018",null,"D3X501_1_1_2018",null,null,"BP3X501_1_1_2018","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4F_1_1_2018","Direct Option 4","D2525_7_1_2009","PREMIER OPTION D","$25","80%(Ded. wavied)","50%","50%","$2,500","N/A","N/A","N/A",null,"C25_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D2525_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001604-1365","2-001604-1365","Oregon - PPO","No Copay","$1,500 Ded","25%","($4,000)","$1,500 Ded","30%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3-100101-2303",null,"3-100101-2303",null,"3-100101-2303","Point of Service","$10","$0","10%","10%","$1,000","$250","30%","$3,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"D3X501_7_1_2009",null,"D3X501_7_1_2009",null,null,"BP3X501_7_1_2009","PPO OPTION B FAMILY DEDUCTIBLE","$50/$150","100%(Ded. wavied)","80%","50%","$1,000","80%(Ded. waived)","60%","50%","$20 Copay","$150 Copay","$75/$150/$225",120,150,150,90,"$120 Copay",20,"DO4A_7_1_2009","Direct Option 4","D2525_PF_7_1_2009","PREMIER OPTION D_PREV FIRST","$25","80%(Ded. wavied)","50%","50%","$2,500","N/A","N/A","N/A",null,"C251_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"D2525_PF_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001604-1400","2-001604-1400","Oregon - PPO","No Copay","$1,500 Ded","25%","($4,000)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5-150101-0000",null,"5-150101-0000",null,"5-150101-0000","Managed Care","$15","$0","10%","10%","$1,000",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"BP3X251_1_1_2018",null,null,"MBPA3X501_1_1_2018","PPO MAC OPTION BPA","$50/$150","100%(Ded. wavied)","90%","50%","$1,000","90%(Ded. waived)","70%","50%","$30 Copay","$300 Copay","$125/$225/$325",150,350,450,150,"$175 Copay",30,"DO7F_1_1_2018","Direct Option 7","DP25_7_1_2009","PPO OPTION D","$25","80%(Ded. wavied)","50%","50%","$1,500","60% Ded. Waived","50%","50%",null,"CP3X502_PF_7_1_2009",null,null,null,null,null,"_7_1_2009",null,null,"DP25_7_1_2009_7_1_2009",null,null,null,null,null,null,null,"2-001606-1313","2-001606-1313","Oregon - PPO","No Copay","$1,500 Ded","25%","($6,000)","$1,500 Ded","30%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CP3X501","DO5C_07012012",null,null,null,"CP251_1_1_2018","PPO OPTION C","$25","80%","80%","50%","$1,000","60%","60%","50%",null,"CP252_PF_1_1_2016",null,null,null,null,null,null,null,null,"CP251_1_1_2018",{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},"2-002222-2304","2-002222-2304","Oregon - PPO","No Copay","$250 Ded","20%","($2,250)","$250 Ded","30%","($4,000)",{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$f":"VLOOKUP(CZ462,[2]Dental2!$Z$49:$AN$82,15,FALSE)","v":{"$error":"#N/A"}}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DP2525_PF_1_1_2018","PPO OPTION D_PREV FIRST","$25","80%(Ded. waived)","50%","50%","$2,500","60% Ded. Waived","50%","50%",null,"DP3X251_1_1_2016",null,null,null,null,null,null,null,null,"DP2525_PF_1_1_2018",{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},"2-002311-2425","2-002311-2425","Oregon - PPO","No Copay","$250 Ded","30%","($1,500)","$250 Ded","40%","($2,500)",{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$error":"#N/A"},{"$f":"VLOOKUP(CZ531,[2]Dental2!$Z$49:$AN$82,15,FALSE)","v":{"$error":"#N/A"}}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-002663-2300","2-002663-2300","Oregon - PPO","No Copay","$250 Ded","25%","($6,350)","$250 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-003205-3410","2-003205-3410","Oregon - PPO","No Copay","$3,000 Ded","20%","($5,000)","$3,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-003304-3405","2-003304-3405","Oregon - PPO","No Copay","$3,000 Ded","30%","($4,000)","$3,000 Ded","40%","($5,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-003605-3410","2-003605-3410","Oregon - PPO","No Copay","$3,000 Ded","25%","($5,000)","$3,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-004206-4508","2-004206-4508","Oregon - PPO","No Copay","$4,000 Ded","20%","($6,000)","$4,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-004306-4500","2-004306-4500","Oregon - PPO","No Copay","$4,000 Ded","30%","($6,000)","$4,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-004606-4508","2-004606-4508","Oregon - PPO","No Copay","$4,000 Ded","25%","($6,000)","$4,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-005203-5555","2-005203-5555","Oregon - PPO","No Copay","$500 Ded","20%","($3,000)","$500 Ded","50%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-005305-5510","2-005305-5510","Oregon - PPO","No Copay","$500 Ded","30%","($5,000)","$500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-006155-6400","2-006155-6400","Oregon - PPO","No Copay","$2,000 Ded","10%","($5,500)","$2,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-006255-6400","2-006255-6400","Oregon - PPO","No Copay","$2,000 Ded","20%","($5,500)","$2,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-006306-6510","2-006306-6510","Oregon - PPO","No Copay","$2,000 Ded","30%","($6,000)","$2,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-007147-7309","2-007147-7309","Oregon - PPO","No Copay","$750 Ded","10%","($4,750)","$750 Ded","30%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-007233-7557","2-007233-7557","Oregon - PPO","No Copay","$750 Ded","20%","($3,250)","$750 Ded","50%","($5,750)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-007357-7513","2-007357-7513","Oregon - PPO","No Copay","$750 Ded","30%","($5,750)","$750 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008163-8410","2-008163-8410","Oregon - PPO","No Copay","$2,500 Ded","10%","($6,350)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008263-8310","2-008263-8310","Oregon - PPO","No Copay","$2,500 Ded","20%","($6,350)","$2,500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-008645-8565","2-008645-8565","Oregon - PPO","No Copay","$2,500 Ded","25%","($4,500)","$2,500 Ded","50%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009163-9500","2-009163-9500","Oregon - PPO","No Copay","$1,000 Ded","10%","($6,350)","$1,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009245-9408","2-009245-9408","Oregon - PPO","No Copay","$1,000 Ded","20%","($4,500)","$1,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-009335-9506","2-009335-9506","Oregon - PPO","No Copay","$1,000 Ded","30%","($3,500)","$1,000 Ded","50%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00D263-D300","2-00D263-D300","Oregon - PPO","No Copay","$5,000 Ded","20%","($6,350)","$5,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00D306-D507","2-00D306-D507","Oregon - PPO","No Copay","$5,000 Ded","30%","($6,000)","$5,000 Ded","50%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00D663-D308","2-00D663-D308","Oregon - PPO","No Copay","$5,000 Ded","25%","($6,350)","$5,000 Ded","30%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00F255-F575","2-00F255-F575","Oregon - PPO","No Copay","$3,500 Ded","20%","($5,500)","$3,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00F363-F400","2-00F363-F400","Oregon - PPO","No Copay","$3,500 Ded","30%","($6,350)","$3,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-00F663-F309","2-00F663-F309","Oregon - PPO","No Copay","$3,500 Ded","25%","($6,350)","$3,500 Ded","30%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-101263-1512","2-101263-1512","Oregon - PPO","$10 Copay","$1,500 Ded","20%","($6,350)","$1,500 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-101335-1555","2-101335-1555","Oregon - PPO","$10 Copay","$1,500 Ded","30%","($3,500)","$1,500 Ded","50%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-102147-2400","2-102147-2400","Oregon - PPO","$10 Copay","$250 Ded","10%","($4,750)","$250 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-102233-2400","2-102233-2400","Oregon - PPO","$10 Copay","$250 Ded","20%","($3,250)","$250 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-102337-2575","2-102337-2575","Oregon - PPO","$10 Copay","$250 Ded","30%","($3,750)","$250 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-103163-3510","2-103163-3510","Oregon - PPO","$10 Copay","$3,000 Ded","10%","($6,350)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-103263-3410","2-103263-3410","Oregon - PPO","$10 Copay","$3,000 Ded","20%","($6,350)","$3,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-103663-3410","2-103663-3410","Oregon - PPO","$10 Copay","$3,000 Ded","25%","($6,350)","$3,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-104205-4306","2-104205-4306","Oregon - PPO","$10 Copay","$4,000 Ded","20%","($5,000)","$4,000 Ded","30%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-104263-4500","2-104263-4500","Oregon - PPO","$10 Copay","$4,000 Ded","20%","($6,350)","$4,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-104605-4306","2-104605-4306","Oregon - PPO","$10 Copay","$4,000 Ded","25%","($5,000)","$4,000 Ded","30%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-105105-5510","2-105105-5510","Oregon - PPO","$10 Copay","$500 Ded","10%","($5,000)","$500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-105263-5500","2-105263-5500","Oregon - PPO","$10 Copay","$500 Ded","20%","($6,350)","$500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-105604-5300","2-105604-5300","Oregon - PPO","$10 Copay","$500 Ded","25%","($4,000)","$500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-106163-6513","2-106163-6513","Oregon - PPO","$10 Copay","$2,000 Ded","10%","($6,350)","$2,000 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-106303-6504","2-106303-6504","Oregon - PPO","$10 Copay","$2,000 Ded","30%","($3,000)","$2,000 Ded","50%","($4,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-107125-7404","2-107125-7404","Oregon - PPO","$10 Copay","$750 Ded","10%","($2,500)","$750 Ded","40%","($4,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-107233-7357","2-107233-7357","Oregon - PPO","$10 Copay","$750 Ded","20%","($3,250)","$750 Ded","30%","($5,750)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-107305-7500","2-107305-7500","Oregon - PPO","$10 Copay","$750 Ded","30%","($5,000)","$750 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-108155-8309","2-108155-8309","Oregon - PPO","$10 Copay","$2,500 Ded","10%","($5,500)","$2,500 Ded","30%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-108245-8300","2-108245-8300","Oregon - PPO","$10 Copay","$2,500 Ded","20%","($4,500)","$2,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-108363-8410","2-108363-8410","Oregon - PPO","$10 Copay","$2,500 Ded","30%","($6,350)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-109135-9300","2-109135-9300","Oregon - PPO","$10 Copay","$1,000 Ded","10%","($3,500)","$1,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-109205-9510","2-109205-9510","Oregon - PPO","$10 Copay","$1,000 Ded","20%","($5,000)","$1,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-109605-9400","2-109605-9400","Oregon - PPO","$10 Copay","$1,000 Ded","25%","($5,000)","$1,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-10D163-D508","2-10D163-D508","Oregon - PPO","$10 Copay","$5,000 Ded","10%","($6,350)","$5,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-10D263-D500","2-10D263-D500","Oregon - PPO","$10 Copay","$5,000 Ded","20%","($6,350)","$5,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-10D363-D508","2-10D363-D508","Oregon - PPO","$10 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-10F163-F409","2-10F163-F409","Oregon - PPO","$10 Copay","$3,500 Ded","10%","($6,350)","$3,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-10F305-F500","2-10F305-F500","Oregon - PPO","$10 Copay","$3,500 Ded","30%","($5,000)","$3,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-151125-1335","2-151125-1335","Oregon - PPO","$15 Copay","$1,500 Ded","10%","($2,500)","$1,500 Ded","30%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-151205-1510","2-151205-1510","Oregon - PPO","$15 Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-151305-1410","2-151305-1410","Oregon - PPO","$15 Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152125-2500","2-152125-2500","Oregon - PPO","$15 Copay","$250 Ded","10%","($2,500)","$250 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152211-2425","2-152211-2425","Oregon - PPO","$15 Copay","$250 Ded","20%","($1,500)","$250 Ded","40%","($2,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-152622-2400","2-152622-2400","Oregon - PPO","$15 Copay","$250 Ded","25%","($2,250)","$250 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-153163-3310","2-153163-3310","Oregon - PPO","$15 Copay","$3,000 Ded","10%","($6,350)","$3,000 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-153255-3308","2-153255-3308","Oregon - PPO","$15 Copay","$3,000 Ded","20%","($5,500)","$3,000 Ded","30%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-153363-3410","2-153363-3410","Oregon - PPO","$15 Copay","$3,000 Ded","30%","($6,350)","$3,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-154163-4409","2-154163-4409","Oregon - PPO","$15 Copay","$4,000 Ded","10%","($6,350)","$4,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-154263-4309","2-154263-4309","Oregon - PPO","$15 Copay","$4,000 Ded","20%","($6,350)","$4,000 Ded","30%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-154663-4409","2-154663-4409","Oregon - PPO","$15 Copay","$4,000 Ded","25%","($6,350)","$4,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155145-5509","2-155145-5509","Oregon - PPO","$15 Copay","$500 Ded","10%","($4,500)","$500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155225-5545","2-155225-5545","Oregon - PPO","$15 Copay","$500 Ded","20%","($2,500)","$500 Ded","50%","($4,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-155335-5565","2-155335-5565","Oregon - PPO","$15 Copay","$500 Ded","30%","($3,500)","$500 Ded","50%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-156105-6310","2-156105-6310","Oregon - PPO","$15 Copay","$2,000 Ded","10%","($5,000)","$2,000 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-156263-6300","2-156263-6300","Oregon - PPO","$15 Copay","$2,000 Ded","20%","($6,350)","$2,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-157105-7310","2-157105-7310","Oregon - PPO","$15 Copay","$750 Ded","10%","($5,000)","$750 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-157147-7509","2-157147-7509","Oregon - PPO","$15 Copay","$750 Ded","10%","($4,750)","$750 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-157257-7300","2-157257-7300","Oregon - PPO","$15 Copay","$750 Ded","20%","($5,750)","$750 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-158106-8310","2-158106-8310","Oregon - PPO","$15 Copay","$2,500 Ded","10%","($6,000)","$2,500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-158205-8310","2-158205-8310","Oregon - PPO","$15 Copay","$2,500 Ded","20%","($5,000)","$2,500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-158263-8400","2-158263-8400","Oregon - PPO","$15 Copay","$2,500 Ded","20%","($6,350)","$2,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-159105-9300","2-159105-9300","Oregon - PPO","$15 Copay","$1,000 Ded","10%","($5,000)","$1,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-159203-9505","2-159203-9505","Oregon - PPO","$15 Copay","$1,000 Ded","20%","($3,000)","$1,000 Ded","50%","($5,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-159305-9515","2-159305-9515","Oregon - PPO","$15 Copay","$1,000 Ded","30%","($5,000)","$1,000 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-15D163-D400","2-15D163-D400","Oregon - PPO","$15 Copay","$5,000 Ded","10%","($6,350)","$5,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-15D263-D308","2-15D263-D308","Oregon - PPO","$15 Copay","$5,000 Ded","20%","($6,350)","$5,000 Ded","30%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-15D363-D408","2-15D363-D408","Oregon - PPO","$15 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-15F163-F509","2-15F163-F509","Oregon - PPO","$15 Copay","$3,500 Ded","10%","($6,350)","$3,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-15F263-F409","2-15F263-F409","Oregon - PPO","$15 Copay","$3,500 Ded","20%","($6,350)","$3,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-201105-1300","2-201105-1300","Oregon - PPO","$20 Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-201135-1400","2-201135-1400","Oregon - PPO","$20 Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-201255-1500","2-201255-1500","Oregon - PPO","$20 Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202105-2400","2-202105-2400","Oregon - PPO","$20 Copay","$250 Ded","10%","($5,000)","$250 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202204-2508","2-202204-2508","Oregon - PPO","$20 Copay","$250 Ded","20%","($4,000)","$250 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-202237-2575","2-202237-2575","Oregon - PPO","$20 Copay","$250 Ded","20%","($3,750)","$250 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-203105-3515","2-203105-3515","Oregon - PPO","$20 Copay","$3,000 Ded","10%","($5,000)","$3,000 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-203204-3505","2-203204-3505","Oregon - PPO","$20 Copay","$3,000 Ded","20%","($4,000)","$3,000 Ded","50%","($5,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-203605-3507","2-203605-3507","Oregon - PPO","$20 Copay","$3,000 Ded","25%","($5,000)","$3,000 Ded","50%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-204163-4300","2-204163-4300","Oregon - PPO","$20 Copay","$4,000 Ded","10%","($6,350)","$4,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-204205-4506","2-204205-4506","Oregon - PPO","$20 Copay","$4,000 Ded","20%","($5,000)","$4,000 Ded","50%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-204363-4400","2-204363-4400","Oregon - PPO","$20 Copay","$4,000 Ded","30%","($6,350)","$4,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205111-5425","2-205111-5425","Oregon - PPO","$20 Copay","$500 Ded","10%","($1,500)","$500 Ded","40%","($2,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205205-5310","2-205205-5310","Oregon - PPO","$20 Copay","$500 Ded","20%","($5,000)","$500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-205304-5475","2-205304-5475","Oregon - PPO","$20 Copay","$500 Ded","30%","($4,000)","$500 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-206163-6300","2-206163-6300","Oregon - PPO","$20 Copay","$2,000 Ded","10%","($6,350)","$2,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-206205-6315","2-206205-6315","Oregon - PPO","$20 Copay","$2,000 Ded","20%","($5,000)","$2,000 Ded","30%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-206304-6506","2-206304-6506","Oregon - PPO","$20 Copay","$2,000 Ded","30%","($4,000)","$2,000 Ded","50%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-206663-6513","2-206663-6513","Oregon - PPO","$20 Copay","$2,000 Ded","25%","($6,350)","$2,000 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-207217-7425","2-207217-7425","Oregon - PPO","$20 Copay","$750 Ded","20%","($1,750)","$750 Ded","40%","($2,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-207647-7400","2-207647-7400","Oregon - PPO","$20 Copay","$750 Ded","25%","($4,750)","$750 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-208155-8400","2-208155-8400","Oregon - PPO","$20 Copay","$2,500 Ded","10%","($5,500)","$2,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-208306-8410","2-208306-8410","Oregon - PPO","$20 Copay","$2,500 Ded","30%","($6,000)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-208663-8410","2-208663-8410","Oregon - PPO","$20 Copay","$2,500 Ded","25%","($6,350)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-209135-9306","2-209135-9306","Oregon - PPO","$20 Copay","$1,000 Ded","10%","($3,500)","$1,000 Ded","30%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-209205-9410","2-209205-9410","Oregon - PPO","$20 Copay","$1,000 Ded","20%","($5,000)","$1,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-209655-9500","2-209655-9500","Oregon - PPO","$20 Copay","$1,000 Ded","25%","($5,500)","$1,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-20D163-D508","2-20D163-D508","Oregon - PPO","$20 Copay","$5,000 Ded","10%","($6,350)","$5,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-20D363-D408","2-20D363-D408","Oregon - PPO","$20 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-20F155-F375","2-20F155-F375","Oregon - PPO","$20 Copay","$3,500 Ded","10%","($5,500)","$3,500 Ded","30%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-20F245-F300","2-20F245-F300","Oregon - PPO","$20 Copay","$3,500 Ded","20%","($4,500)","$3,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-20F305-F400","2-20F305-F400","Oregon - PPO","$20 Copay","$3,500 Ded","30%","($5,000)","$3,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251135-1400","2-251135-1400","Oregon - PPO","$25 Copay","$1,500 Ded","10%","($3,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251205-1509","2-251205-1509","Oregon - PPO","$25 Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-251635-1455","2-251635-1455","Oregon - PPO","$25 Copay","$1,500 Ded","25%","($3,500)","$1,500 Ded","40%","($5,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-252104-2508","2-252104-2508","Oregon - PPO","$25 Copay","$250 Ded","10%","($4,000)","$250 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-252205-2415","2-252205-2415","Oregon - PPO","$25 Copay","$250 Ded","20%","($5,000)","$250 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-252625-2547","2-252625-2547","Oregon - PPO","$25 Copay","$250 Ded","25%","($2,500)","$250 Ded","50%","($4,750)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-253155-3500","2-253155-3500","Oregon - PPO","$25 Copay","$3,000 Ded","10%","($5,500)","$3,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-253263-3500","2-253263-3500","Oregon - PPO","$25 Copay","$3,000 Ded","20%","($6,350)","$3,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-253663-3400","2-253663-3400","Oregon - PPO","$25 Copay","$3,000 Ded","25%","($6,350)","$3,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-254163-4309","2-254163-4309","Oregon - PPO","$25 Copay","$4,000 Ded","10%","($6,350)","$4,000 Ded","30%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-254363-4409","2-254363-4409","Oregon - PPO","$25 Copay","$4,000 Ded","30%","($6,350)","$4,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-254663-4500","2-254663-4500","Oregon - PPO","$25 Copay","$4,000 Ded","25%","($6,350)","$4,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255125-5500","2-255125-5500","Oregon - PPO","$25 Copay","$500 Ded","10%","($2,500)","$500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255235-5400","2-255235-5400","Oregon - PPO","$25 Copay","$500 Ded","20%","($3,500)","$500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-255645-5400","2-255645-5400","Oregon - PPO","$25 Copay","$500 Ded","25%","($4,500)","$500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-256145-6400","2-256145-6400","Oregon - PPO","$25 Copay","$2,000 Ded","10%","($4,500)","$2,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-256205-6515","2-256205-6515","Oregon - PPO","$25 Copay","$2,000 Ded","20%","($5,000)","$2,000 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257104-7475","2-257104-7475","Oregon - PPO","$25 Copay","$750 Ded","10%","($4,000)","$750 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257133-7357","2-257133-7357","Oregon - PPO","$25 Copay","$750 Ded","10%","($3,250)","$750 Ded","30%","($5,750)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257357-7513","2-257357-7513","Oregon - PPO","$25 Copay","$750 Ded","30%","($5,750)","$750 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-257605-7509","2-257605-7509","Oregon - PPO","$25 Copay","$750 Ded","25%","($5,000)","$750 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-258163-8300","2-258163-8300","Oregon - PPO","$25 Copay","$2,500 Ded","10%","($6,350)","$2,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-258363-8500","2-258363-8500","Oregon - PPO","$25 Copay","$2,500 Ded","30%","($6,350)","$2,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-258663-8310","2-258663-8310","Oregon - PPO","$25 Copay","$2,500 Ded","25%","($6,350)","$2,500 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259204-9507","2-259204-9507","Oregon - PPO","$25 Copay","$1,000 Ded","20%","($4,000)","$1,000 Ded","50%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259345-9400","2-259345-9400","Oregon - PPO","$25 Copay","$1,000 Ded","30%","($4,500)","$1,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-259606-9512","2-259606-9512","Oregon - PPO","$25 Copay","$1,000 Ded","25%","($6,000)","$1,000 Ded","50%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-25D163-D408","2-25D163-D408","Oregon - PPO","$25 Copay","$5,000 Ded","10%","($6,350)","$5,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-25D663-D300","2-25D663-D300","Oregon - PPO","$25 Copay","$5,000 Ded","25%","($6,350)","$5,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-25F106-F409","2-25F106-F409","Oregon - PPO","$25 Copay","$3,500 Ded","10%","($6,000)","$3,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-25F163-F509","2-25F163-F509","Oregon - PPO","$25 Copay","$3,500 Ded","10%","($6,350)","$3,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-25F605-F510","2-25F605-F510","Oregon - PPO","$25 Copay","$3,500 Ded","25%","($5,000)","$3,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301105-1415","2-301105-1415","Oregon - PPO","$30 Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301325-1400","2-301325-1400","Oregon - PPO","$30 Copay","$1,500 Ded","30%","($2,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-301645-1300","2-301645-1300","Oregon - PPO","$30 Copay","$1,500 Ded","25%","($4,500)","$1,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-302105-2510","2-302105-2510","Oregon - PPO","$30 Copay","$250 Ded","10%","($5,000)","$250 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-302325-2400","2-302325-2400","Oregon - PPO","$30 Copay","$250 Ded","30%","($2,500)","$250 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-302605-2510","2-302605-2510","Oregon - PPO","$30 Copay","$250 Ded","25%","($5,000)","$250 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-303106-3409","2-303106-3409","Oregon - PPO","$30 Copay","$3,000 Ded","10%","($6,000)","$3,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-303363-3400","2-303363-3400","Oregon - PPO","$30 Copay","$3,000 Ded","30%","($6,350)","$3,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-303663-3300","2-303663-3300","Oregon - PPO","$30 Copay","$3,000 Ded","25%","($6,350)","$3,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-304205-4310","2-304205-4310","Oregon - PPO","$30 Copay","$4,000 Ded","20%","($5,000)","$4,000 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-304363-4500","2-304363-4500","Oregon - PPO","$30 Copay","$4,000 Ded","30%","($6,350)","$4,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-304663-4400","2-304663-4400","Oregon - PPO","$30 Copay","$4,000 Ded","25%","($6,350)","$4,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305105-5410","2-305105-5410","Oregon - PPO","$30 Copay","$500 Ded","10%","($5,000)","$500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305345-5509","2-305345-5509","Oregon - PPO","$30 Copay","$500 Ded","30%","($4,500)","$500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-305635-5400","2-305635-5400","Oregon - PPO","$30 Copay","$500 Ded","25%","($3,500)","$500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-306255-6500","2-306255-6500","Oregon - PPO","$30 Copay","$2,000 Ded","20%","($5,500)","$2,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-306355-6509","2-306355-6509","Oregon - PPO","$30 Copay","$2,000 Ded","30%","($5,500)","$2,000 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-306655-6500","2-306655-6500","Oregon - PPO","$30 Copay","$2,000 Ded","25%","($5,500)","$2,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307257-7300","2-307257-7300","Oregon - PPO","$30 Copay","$750 Ded","20%","($5,750)","$750 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307617-7425","2-307617-7425","Oregon - PPO","$30 Copay","$750 Ded","25%","($1,750)","$750 Ded","40%","($2,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-307647-7400","2-307647-7400","Oregon - PPO","$30 Copay","$750 Ded","25%","($4,750)","$750 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-308263-8500","2-308263-8500","Oregon - PPO","$30 Copay","$2,500 Ded","20%","($6,350)","$2,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-308363-8510","2-308363-8510","Oregon - PPO","$30 Copay","$2,500 Ded","30%","($6,350)","$2,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-308663-8500","2-308663-8500","Oregon - PPO","$30 Copay","$2,500 Ded","25%","($6,350)","$2,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-309245-9500","2-309245-9500","Oregon - PPO","$30 Copay","$1,000 Ded","20%","($4,500)","$1,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-309347-9409","2-309347-9409","Oregon - PPO","$30 Copay","$1,000 Ded","30%","($4,750)","$1,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-30D163-D408","2-30D163-D408","Oregon - PPO","$30 Copay","$5,000 Ded","10%","($6,350)","$5,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-30D306-D407","2-30D306-D407","Oregon - PPO","$30 Copay","$5,000 Ded","30%","($6,000)","$5,000 Ded","40%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-30D663-D308","2-30D663-D308","Oregon - PPO","$30 Copay","$5,000 Ded","25%","($6,350)","$5,000 Ded","30%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-30F145-F500","2-30F145-F500","Oregon - PPO","$30 Copay","$3,500 Ded","10%","($4,500)","$3,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-30F355-F575","2-30F355-F575","Oregon - PPO","$30 Copay","$3,500 Ded","30%","($5,500)","$3,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-30F663-F300","2-30F663-F300","Oregon - PPO","$30 Copay","$3,500 Ded","25%","($6,350)","$3,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-351105-1415","2-351105-1415","Oregon - PPO","$35 Copay","$1,500 Ded","10%","($5,000)","$1,500 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-351305-1409","2-351305-1409","Oregon - PPO","$35 Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-351625-1535","2-351625-1535","Oregon - PPO","$35 Copay","$1,500 Ded","25%","($2,500)","$1,500 Ded","50%","($3,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-352225-2447","2-352225-2447","Oregon - PPO","$35 Copay","$250 Ded","20%","($2,500)","$250 Ded","40%","($4,750)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-352604-2308","2-352604-2308","Oregon - PPO","$35 Copay","$250 Ded","25%","($4,000)","$250 Ded","30%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-352625-2500","2-352625-2500","Oregon - PPO","$35 Copay","$250 Ded","25%","($2,500)","$250 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-353263-3310","2-353263-3310","Oregon - PPO","$35 Copay","$3,000 Ded","20%","($6,350)","$3,000 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-353363-3410","2-353363-3410","Oregon - PPO","$35 Copay","$3,000 Ded","30%","($6,350)","$3,000 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-353663-3510","2-353663-3510","Oregon - PPO","$35 Copay","$3,000 Ded","25%","($6,350)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-354263-4409","2-354263-4409","Oregon - PPO","$35 Copay","$4,000 Ded","20%","($6,350)","$4,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-354363-4509","2-354363-4509","Oregon - PPO","$35 Copay","$4,000 Ded","30%","($6,350)","$4,000 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-355111-5425","2-355111-5425","Oregon - PPO","$35 Copay","$500 Ded","10%","($1,500)","$500 Ded","40%","($2,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-355255-5313","2-355255-5313","Oregon - PPO","$35 Copay","$500 Ded","20%","($5,500)","$500 Ded","30%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-355363-5412","2-355363-5412","Oregon - PPO","$35 Copay","$500 Ded","30%","($6,350)","$500 Ded","40%","($12,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-355645-5400","2-355645-5400","Oregon - PPO","$35 Copay","$500 Ded","25%","($4,500)","$500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-356205-6515","2-356205-6515","Oregon - PPO","$35 Copay","$2,000 Ded","20%","($5,000)","$2,000 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-356603-6300","2-356603-6300","Oregon - PPO","$35 Copay","$2,000 Ded","25%","($3,000)","$2,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-357204-7500","2-357204-7500","Oregon - PPO","$35 Copay","$750 Ded","20%","($4,000)","$750 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-357257-7513","2-357257-7513","Oregon - PPO","$35 Copay","$750 Ded","20%","($5,750)","$750 Ded","50%","($10,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-357604-7475","2-357604-7475","Oregon - PPO","$35 Copay","$750 Ded","25%","($4,000)","$750 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-358205-8575","2-358205-8575","Oregon - PPO","$35 Copay","$2,500 Ded","20%","($5,000)","$2,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-358363-8410","2-358363-8410","Oregon - PPO","$35 Copay","$2,500 Ded","30%","($6,350)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-358605-8415","2-358605-8415","Oregon - PPO","$35 Copay","$2,500 Ded","25%","($5,000)","$2,500 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-359204-9407","2-359204-9407","Oregon - PPO","$35 Copay","$1,000 Ded","20%","($4,000)","$1,000 Ded","40%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-359302-9403","2-359302-9403","Oregon - PPO","$35 Copay","$1,000 Ded","30%","($2,000)","$1,000 Ded","40%","($3,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-359605-9309","2-359605-9309","Oregon - PPO","$35 Copay","$1,000 Ded","25%","($5,000)","$1,000 Ded","30%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-35D263-D400","2-35D263-D400","Oregon - PPO","$35 Copay","$5,000 Ded","20%","($6,350)","$5,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-35D363-D408","2-35D363-D408","Oregon - PPO","$35 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-35F163-F400","2-35F163-F400","Oregon - PPO","$35 Copay","$3,500 Ded","10%","($6,350)","$3,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-35F263-F409","2-35F263-F409","Oregon - PPO","$35 Copay","$3,500 Ded","20%","($6,350)","$3,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-35F363-F509","2-35F363-F509","Oregon - PPO","$35 Copay","$3,500 Ded","30%","($6,350)","$3,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-35F663-F409","2-35F663-F409","Oregon - PPO","$35 Copay","$3,500 Ded","25%","($6,350)","$3,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-401205-1415","2-401205-1415","Oregon - PPO","$40 Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-401604-1465","2-401604-1465","Oregon - PPO","$40 Copay","$1,500 Ded","25%","($4,000)","$1,500 Ded","40%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-402205-2300","2-402205-2300","Oregon - PPO","$40 Copay","$250 Ded","20%","($5,000)","$250 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-402237-2575","2-402237-2575","Oregon - PPO","$40 Copay","$250 Ded","20%","($3,750)","$250 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-402605-2310","2-402605-2310","Oregon - PPO","$40 Copay","$250 Ded","25%","($5,000)","$250 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-403205-3407","2-403205-3407","Oregon - PPO","$40 Copay","$3,000 Ded","20%","($5,000)","$3,000 Ded","40%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-403263-3510","2-403263-3510","Oregon - PPO","$40 Copay","$3,000 Ded","20%","($6,350)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-403604-3505","2-403604-3505","Oregon - PPO","$40 Copay","$3,000 Ded","25%","($4,000)","$3,000 Ded","50%","($5,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-404206-4500","2-404206-4500","Oregon - PPO","$40 Copay","$4,000 Ded","20%","($6,000)","$4,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-404306-4408","2-404306-4408","Oregon - PPO","$40 Copay","$4,000 Ded","30%","($6,000)","$4,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-404663-4409","2-404663-4409","Oregon - PPO","$40 Copay","$4,000 Ded","25%","($6,350)","$4,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-405205-5500","2-405205-5500","Oregon - PPO","$40 Copay","$500 Ded","20%","($5,000)","$500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-405305-5510","2-405305-5510","Oregon - PPO","$40 Copay","$500 Ded","30%","($5,000)","$500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-406105-6308","2-406105-6308","Oregon - PPO","$40 Copay","$2,000 Ded","10%","($5,000)","$2,000 Ded","30%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-406206-6310","2-406206-6310","Oregon - PPO","$40 Copay","$2,000 Ded","20%","($6,000)","$2,000 Ded","30%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-406306-6500","2-406306-6500","Oregon - PPO","$40 Copay","$2,000 Ded","30%","($6,000)","$2,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-407137-7565","2-407137-7565","Oregon - PPO","$40 Copay","$750 Ded","10%","($3,750)","$750 Ded","50%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-407205-7400","2-407205-7400","Oregon - PPO","$40 Copay","$750 Ded","20%","($5,000)","$750 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-407333-7557","2-407333-7557","Oregon - PPO","$40 Copay","$750 Ded","30%","($3,250)","$750 Ded","50%","($5,750)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-408163-8410","2-408163-8410","Oregon - PPO","$40 Copay","$2,500 Ded","10%","($6,350)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-408263-8400","2-408263-8400","Oregon - PPO","$40 Copay","$2,500 Ded","20%","($6,350)","$2,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-408363-8410","2-408363-8410","Oregon - PPO","$40 Copay","$2,500 Ded","30%","($6,350)","$2,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-409163-9300","2-409163-9300","Oregon - PPO","$40 Copay","$1,000 Ded","10%","($6,350)","$1,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-409245-9300","2-409245-9300","Oregon - PPO","$40 Copay","$1,000 Ded","20%","($4,500)","$1,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-409655-9510","2-409655-9510","Oregon - PPO","$40 Copay","$1,000 Ded","25%","($5,500)","$1,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-40D263-D300","2-40D263-D300","Oregon - PPO","$40 Copay","$5,000 Ded","20%","($6,350)","$5,000 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-40D306-D407","2-40D306-D407","Oregon - PPO","$40 Copay","$5,000 Ded","30%","($6,000)","$5,000 Ded","40%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-40D663-D408","2-40D663-D408","Oregon - PPO","$40 Copay","$5,000 Ded","25%","($6,350)","$5,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-40F263-F300","2-40F263-F300","Oregon - PPO","$40 Copay","$3,500 Ded","20%","($6,350)","$3,500 Ded","30%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2-40F355-F575","2-40F355-F575","Oregon - PPO","$40 Copay","$3,500 Ded","30%","($5,500)","$3,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5-256305-0000","5-256305-0000","Oregon - MC","$25 Copay","$2,000 Ded","30%","($5,000)","No Ded","0%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-20D263-D500","B-20D263-D500","Oregon - Beneficial PPO","$20 Copay","$5,000 Ded","20%","($6,350)","$5,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-251305-1510","B-251305-1510","Oregon - Beneficial PPO","$25 Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-251363-1510","B-251363-1510","Oregon - Beneficial PPO","$25 Copay","$1,500 Ded","30%","($6,350)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-253305-3510","B-253305-3510","Oregon - Beneficial PPO","$25 Copay","$3,000 Ded","30%","($5,000)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-253363-3510","B-253363-3510","Oregon - Beneficial PPO","$25 Copay","$3,000 Ded","30%","($6,350)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-254363-4510","B-254363-4510","Oregon - Beneficial PPO","$25 Copay","$4,000 Ded","30%","($6,350)","$4,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-256305-4510","B-256305-4510","Oregon - Beneficial PPO","$25 Copay","$2,000 Ded","30%","($5,000)","$4,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-256305-6510","B-256305-6510","Oregon - Beneficial PPO","$25 Copay","$2,000 Ded","30%","($5,000)","$2,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-256363-4510","B-256363-4510","Oregon - Beneficial PPO","$25 Copay","$2,000 Ded","30%","($6,350)","$4,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-256363-6510","B-256363-6510","Oregon - Beneficial PPO","$25 Copay","$2,000 Ded","30%","($6,350)","$2,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-258305-8510","B-258305-8510","Oregon - Beneficial PPO","$25 Copay","$2,500 Ded","30%","($5,000)","$2,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-258363-8510","B-258363-8510","Oregon - Beneficial PPO","$25 Copay","$2,500 Ded","30%","($6,350)","$2,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-259305-3510","B-259305-3510","Oregon - Beneficial PPO","$25 Copay","$1,000 Ded","30%","($5,000)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-259363-3510","B-259363-3510","Oregon - Beneficial PPO","$25 Copay","$1,000 Ded","30%","($6,350)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25D363-D500","B-25D363-D500","Oregon - Beneficial PPO","$25 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25D363-D510","B-25D363-D510","Oregon - Beneficial PPO","$25 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25D363-D527","B-25D363-D527","Oregon - Beneficial PPO","$25 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","50%","($12,700)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25F305-F510","B-25F305-F510","Oregon - Beneficial PPO","$25 Copay","$3,500 Ded","30%","($5,000)","$3,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25F305-F515","B-25F305-F515","Oregon - Beneficial PPO","$25 Copay","$3,500 Ded","30%","($5,000)","$3,500 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25F363-F500","B-25F363-F500","Oregon - Beneficial PPO","$25 Copay","$3,500 Ded","30%","($6,350)","$3,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25F363-F510","B-25F363-F510","Oregon - Beneficial PPO","$25 Copay","$3,500 Ded","30%","($6,350)","$3,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-25F363-F515","B-25F363-F515","Oregon - Beneficial PPO","$25 Copay","$3,500 Ded","30%","($6,350)","$3,500 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-30F363-F500","B-30F363-F500","Oregon - Beneficial PPO","$30 Copay","$3,500 Ded","30%","($6,350)","$3,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"B-40D363-D500","B-40D363-D500","Oregon - Beneficial PPO","$40 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-001205-1409","H-001205-1409","Oregon - HSA PPO","No Copay","$1,500 Ded","20%","($5,000)","$1,500 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-001206-1410","H-001206-1410","Oregon - HSA PPO","No Copay","$1,500 Ded","20%","($6,000)","$1,500 Ded","40%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-001255-1400","H-001255-1400","Oregon - HSA PPO","No Copay","$1,500 Ded","20%","($5,500)","$1,500 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-001555-1500","H-001555-1500","Oregon - HSA PPO","No Copay","$1,500 Ded","50%","($5,500)","$1,500 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-003205-3407","H-003205-3407","Oregon - HSA PPO","No Copay","$3,000 Ded","20%","($5,000)","$3,000 Ded","40%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-003206-3400","H-003206-3400","Oregon - HSA PPO","No Copay","$3,000 Ded","20%","($6,000)","$3,000 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-003206-3409","H-003206-3409","Oregon - HSA PPO","No Copay","$3,000 Ded","20%","($6,000)","$3,000 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-004005-4500","H-004005-4500","Oregon - HSA PPO","No Copay","$4,000 Ded","0%","($5,000)","$4,000 Ded","50%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-004205-4406","H-004205-4406","Oregon - HSA PPO","No Copay","$4,000 Ded","20%","($5,000)","$4,000 Ded","40%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-004206-4508","H-004206-4508","Oregon - HSA PPO","No Copay","$4,000 Ded","20%","($6,000)","$4,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-004505-4506","H-004505-4506","Oregon - HSA PPO","No Copay","$4,000 Ded","50%","($5,000)","$4,000 Ded","50%","($6,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-006205-6408 ","H-006205-6408 ","Oregon - HSA PPO","No Copay","$2,000 Ded","20%","($5,000)","$2,000 Ded","40%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-006205-6508","H-006205-6508","Oregon - HSA PPO","No Copay","$2,000 Ded","20%","($5,000)","$2,000 Ded","50%","($8,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-008305-8575","H-008305-8575","Oregon - HSA PPO","No Copay","$2,500 Ded","30%","($5,000)","$2,500 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-008605-8475","H-008605-8475","Oregon - HSA PPO","No Copay","$2,500 Ded","25%","($5,000)","$2,500 Ded","40%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00D563-D575","H-00D563-D575","Oregon - HSA PPO","No Copay","$5,000 Ded","50%","($6,350)","$5,000 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00F205-F465","H-00F205-F465","Oregon - HSA PPO","No Copay","$3,500 Ded","20%","($5,000)","$3,500 Ded","40%","($6,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00F306-F509","H-00F306-F509","Oregon - HSA PPO","No Copay","$3,500 Ded","30%","($6,000)","$3,500 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00H505-H507","H-00H505-H507","Oregon - HSA PPO","No Copay","$2,800 Ded","50%","($5,000)","$2,800 Ded","50%","($7,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00H506-H575","H-00H506-H575","Oregon - HSA PPO","No Copay","$2,800 Ded","50%","($6,000)","$2,800 Ded","50%","($7,500)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00L205-L400","H-00L205-L400","Oregon - HSA PPO","No Copay","$1,250 Ded","20%","($5,000)","$1,250 Ded","40%","No OOP Max"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00L205-L409","H-00L205-L409","Oregon - HSA PPO","No Copay","$1,250 Ded","20%","($5,000)","$1,250 Ded","40%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H-00L205-L509","H-00L205-L509","Oregon - HSA PPO","No Copay","$1,250 Ded","20%","($5,000)","$1,250 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-251305-1510","V-251305-1510","Oregon - Value PPO","$25 Copay","$1,500 Ded","30%","($5,000)","$1,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-251305-3510","V-251305-3510","Oregon - Value PPO","$25 Copay","$1,500 Ded","30%","($5,000)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-253305-A510","V-253305-A510","Oregon - Value PPO","$25 Copay","$3,000 Ded","30%","($5,000)","$6,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-254305-C510","V-254305-C510","Oregon - Value PPO","$25 Copay","$4,000 Ded","30%","($5,000)","$8,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-256305-4510","V-256305-4510","Oregon - Value PPO","$25 Copay","$2,000 Ded","30%","($5,000)","$4,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-256305-8510","V-256305-8510","Oregon - Value PPO","$25 Copay","$2,000 Ded","30%","($5,000)","$2,500 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-258305-A510","V-258305-A510","Oregon - Value PPO","$25 Copay","$2,500 Ded","30%","($5,000)","$6,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-258305-D510","V-258305-D510","Oregon - Value PPO","$25 Copay","$2,500 Ded","30%","($5,000)","$5,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-259305-3510","V-259305-3510","Oregon - Value PPO","$25 Copay","$1,000 Ded","30%","($5,000)","$3,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-259305-6510","V-259305-6510","Oregon - Value PPO","$25 Copay","$1,000 Ded","30%","($5,000)","$2,000 Ded","50%","($10,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-25D363-G527","V-25D363-G527","Oregon - Value PPO","$25 Copay","$5,000 Ded","30%","($6,350)","$10,000 Ded","50%","($12,700)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"V-35D363-D515","V-35D363-D515","Oregon - Value PPO","$35 Copay","$5,000 Ded","30%","($6,350)","$5,000 Ded","50%","($15,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"W-259205-9509","W-259205-9509","Oregon - Well Connect","$25 Copay","$1,000 Ded","20%","($5,000)","$1,000 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"W-256205-6509","W-256205-6509","Oregon - Well Connect","$25 Copay","$2,000 Ded","20%","($5,000)","$2,000 Ded","50%","($9,000)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"W-253205-3509","W-253205-3509","Oregon - Well Connect","$25 Copay","$3,000 Ded","20%","($5,000)","$3,000 Ded","50%","($9,000)"]

{"sheet":"Plan Info Lookups","index":4,"n_rows":117,"n_cols":30,"rows_kept":117,"cut":false,"hidden":true,"merged":[]}
[]
["Medical 11-Digit Plan Codes",null,null,null,null,null,"Yellow cells are drop down boxes.  Select your plan's benefit and 11 digit code will populate below."]
[]
[null,null,null,null,null,null,"Plan Type","OV Copay","In-Net Ded","In-Net Coins",null,"In-Net OOP",null,"Out Ded","Out Coins","Out OOP"]
[null,null,null,"Your Plan:",null,null,"PPO","$30","$2000","20%",null,"$3,000",null,"$2000","50%","$15,000"]
[]
[null,null,null,"Your Plan's Code:",null,null,{"$f":"IFERROR(VLOOKUP(G5,C59:D69,2,FALSE)&\"-\"&VLOOKUP(H5,H59:I66,2,FALSE)&VLOOKUP(I5,N59:O373,2,FALSE)&VLOOKUP(J5,T59:U66,2,FALSE)&VLOOKUP(L5,AA60:AB85,2,FALSE)&\"-\"&VLOOKUP(N5,N59:O84,2,FALSE)&VLOOKUP(O5,T59:U66,2,FALSE)&VLOOKUP(P5,AA60:AB115,2,FALSE),\"\")","v":"2-306203-6515"}]
[]
[null,null,null,"Your Plan's Description:",null,null,{"$f":"IF(G5=\"Beneficial PPO\",G5&\" : \"&H5&\"(5) OV, \"&I5&\" In-net Ded, \"&J5&\" (\"&L5&\")\"&\"; Out: \"&N5&\" Ded, \"&O5&\" (\"&P5&\")\",IF(G5=\"HSA PPO\",G5&\" : \"&I5&\" In-net Ded, \"&J5&\" (\"&L5&\")\"&\"; Out: \"&N5&\" Ded, \"&O5&\" (\"&P5&\")\",G5&\" : \"&H5&\" OV, \"&I5&\" In-net Ded, \"&J5&\" (\"&L5&\")\"&\"; Out: \"&N5&\" Ded, \"&O5&\" (\"&P5&\")\"))","v":"PPO : $30 OV, $2000 In-net Ded, 20% ($3,000); Out: $2000 Ded, 50% ($15,000)"}]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"Example:","2-150202-2404"," = PPO Copay: $15 ov, 20% ($2,000),Out: $250 Ded/ 40% ($4,000)"]
[null,null,"A-BBCDEE-FGHH"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"Plan Type Options: A",null,null,null,null,"OV Copay Options - BB",null,null,null,null,null,"Deduct Options: C and F",null,null,null,null,null,"Coinsurance: D and G",null,null,null,null,null,null,"OOP Max - EE and  HH"]
[null,"Source:","Quotes_51.xls",null,null,null,"Source:","Quotes_51.xls",null,null,null,null,"Source:","Quotes_51.xls",null,null,null,null,"Source:","Quotes_51.xls",null,null,null,null,null,"Source:","Quotes_51.xls"]
[null,"Updated:","2/28/2008 TS",null,null,null,"Updated:","2/28/2008 TS",null,null,null,null,"Updated:","2/28/2008 TS",null,null,null,null,"Updated:","2/28/2008 TS",null,null,null,null,null,"Updated:","2/28/2008 TS"]
[null,"Notes:","Named Range \"PlanID_type\"",null,null,null,null,"Named Range \"PlanID_Copay\"",null,null,null,null,"Notes:","Named Range \"PlanID_ded\"",null,null,null,null,"Notes:","Named Range \"PlanID_coinsurance\"",null,null,null,null,null,"Notes:","Named Range \"PlanID_OOP\""]
[]
[]
[null,"Code","Description","Code (restated)",null,null,"Code","Description","Code (restated)","Copay Value",null,null,"Code","Description","Code (restated)","Deductible Value",null,null,"Code","Description","Code (restated)","Coinsurance Value","HSA RX Descriptoin",null,null,"Code","Description","Code (restated)","Value"]
[null,"1","Indemnity (51+)","1",1,null,"00","No Copay","00",0,1,null,"0","No Ded","0",0,1,null,"0","0%","0",0,"100% MM RX Subject to Deductible",1,null,"00","No OOP Max","00",0,1]
[null,"2","PPO","2",2,null,"10","$10","10",10,2,null,"2","$250","2",250,2,null,"1","10%","1",0.1,"90% MM RX Subject to Deductible",2,null,"01","$1,000","01",1000,2]
[null,"3","POS","3",3,null,"15","$15","15",15,3,null,"5","$500","5",500,3,null,"2","20%","2",0.2,"80% MM RX Subject to Deductible",3,null,"11","$1,500","11",1500,3]
[null,"5","MC","5",4,null,"20","$20","20",20,4,null,"7","$750","7",750,4,null,"6","25%","6",0.25,"75% MM RX Subject to Deductible",4,null,"16","$1,600","16",1600,4]
[null,"B","Beneficial PPO","B",6,null,"25","$25","25",25,5,null,"9","$1000","9",1000,5,null,"3","30%","3",0.3,"70% MM RX Subject to Deductible",5,null,"17","$1,750","17",1750,5]
[null,"E","HSA Embedded Individual OOP","E",7,null,"30","$30","30",30,6,null,"L","$1200","L",1200,6,null,"4","40%","4",0.4,"60% MM RX Subject to Deductible",6,null,"02","$2,000","02",2000,6]
[null,"D","HSA PPO Deductible Embedded","D",8,null,"35","$35","35",35,7,null,"R","$1300","R",1300,7,null,"5","50%","5",0.5,"50% MM RX Subject to Deductible",7,null,"LG","$2,200","LG",2200,7]
[null,"H","HSA PPO","H",9,null,"40","$40","40",40,8,null,"X","$1,350","X",1350,31,null,"7","$100/Day In-Hosp (5), 10% Coins","7","NA",null,8,null,"22","$2,250","22",2250,8]
[null,"U","Summit PPO","U",11,null,"50","$50","50",50,null,null,"1","$1500","1",1500,8,null,null,null,null,null,null,null,null,"25","$2,500","25",2500,9]
[null,"V","Value PPO","V",13,null,"75","$75","75",75,null,null,"6","$2000","6",2000,9,null,null,null,null,null,null,null,null,"28","$2,800","28",2800,10]
[null,"Y","Synergy PPO","Y",14,null,null,null,null,null,null,null,"T","$2400","T",2400,10,null,null,null,null,null,null,null,null,"03","$3,000","03",3000,11]
[null,null,null,null,null,null,null,null,null,null,null,null,"8","$2500","8",2500,11,null,null,null,null,null,null,null,null,"32","$3,200","32",3200,12]
[null,null,null,null,null,null,null,null,null,null,null,null,"S","$2600","S",2600,12,null,null,null,null,null,null,null,null,"33","$3,250","33",3250,13]
[null,null,null,null,null,null,null,null,null,null,null,null,"Z","$2,700","Z",2700,32,null,null,null,null,null,null,null,null,"34","$3,275","34",3275,14]
[null,null,null,null,null,null,null,null,null,null,null,null,"H","$2800","H",2800,13,null,null,null,null,null,null,null,null,"35","$3,500","35",3500,15]
[null,null,null,null,null,null,null,null,null,null,null,null,"3","$3000","3",3000,14,null,null,null,null,null,null,null,null,"37","$3,750","37",3750,16]
[null,null,null,null,null,null,null,null,null,null,null,null,"U","$3,275","U",3275,15,null,null,null,null,null,null,null,null,"SM","$3,800","SM",3800,17]
[null,null,null,null,null,null,null,null,null,null,null,null,"F","$3500","F",3500,16,null,null,null,null,null,null,null,null,"04","$4,000","04",4000,18]
[null,null,null,null,null,null,null,null,null,null,null,null,"4","$4000","4",4000,17,null,null,null,null,null,null,null,null,"MX","$4,400","MX",4400,19]
[null,null,null,null,null,null,null,null,null,null,null,null,"Q","$4500","Q",4500,18,null,null,null,null,null,null,null,null,"45","$4,500","45",4500,20]
[null,null,null,null,null,null,null,null,null,null,null,null,"D","$5000","D",5000,19,null,null,null,null,null,null,null,null,"47","$4,750","47",4750,21]
[null,null,null,null,null,null,null,null,null,null,null,null,"B","$5600","B",5600,20,null,null,null,null,null,null,null,null,"05","$5,000","05",5000,22]
[null,null,null,null,null,null,null,null,null,null,null,null,"A","$6000","A",6000,21,null,null,null,null,null,null,null,null,"52","$5,250","52",5250,23]
[null,null,null,null,null,null,null,null,null,null,null,null,"M","$7000","M",7000,22,null,null,null,null,null,null,null,null,"55","$5,500","55",5500,24]
[null,null,null,null,null,null,null,null,null,null,null,null,"E","$7500","E",7500,23,null,null,null,null,null,null,null,null,"57","$5,750","57",5750,25]
[null,null,null,null,null,null,null,null,null,null,null,null,"C","$8000","C",8000,24,null,null,null,null,null,null,null,null,"06","$6,000","06",6000,26]
[null,null,null,null,null,null,null,null,null,null,null,null,"P","$9000","P",9000,25,null,null,null,null,null,null,null,null,"63","$6,350","63",6350,27]
[null,null,null,null,null,null,null,null,null,null,null,null,"G","$10000","G",10000,26,null,null,null,null,null,null,null,null,"64","$6,400","64",6400,28]
[null,null,null,null,null,null,null,null,null,null,null,null,"I","$15000","I",15000,27,null,null,null,null,null,null,null,null,"19","$6,450","19",6450,29]
[null,null,null,null,null,null,null,null,null,null,null,null,"N","$21,000","N",21000,28,null,null,null,null,null,null,null,null,"65","$6,500","65",6500,30]
[null,null,null,null,null,null,null,null,null,null,null,null,"J","$22,500","J",22500,29,null,null,null,null,null,null,null,null,"67","$6,550","67",6550,31]
[null,null,null,null,null,null,null,null,null,null,null,null,"K","$30,000","K",30000,30,null,null,null,null,null,null,null,null,"66","$6,600","66",6600,32]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H6","$6,650","H6",6650,56]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H1","$6,850","H1",6850,33]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"07","$7,000","07",7000,34]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"71","$7,150","71",7150,35]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H8","$7,350","H8",7350,58]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"75","$7,500","75",7500,36]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"MN","$7,600","MN",7600,37]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"08","$8,000","08",8000,38]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"85","$8,500","85",8500,39]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"09","$9,000","09",9000,40]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"10","$10,000","10",10000,41]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"13","$10,500","13",10500,42]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"56","$11,000","56",11000,43]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"12","$12,000","12",12000,44]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"29","$12,500","29",12500,45]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"27","$12,700","27",12700,46]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"62","$12,900","62",12900,47]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"43","$13,100","43",13100,48]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"86","$13,200","86",13200,49]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H7","$13,300","H7",13300,57]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"14","$13,500","14",13500,50]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H2","$13,700","H2",13700,51]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"74","$14,300","74",14300,52]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"H9","$14,700","H9",14700,59]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"15","$15,000","15",15000,53]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"87","$20,000","87",20000,54]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30","$30,000","30",30000,55]

{"sheet":"Page 4 - Rates Insured","index":5,"n_rows":38,"n_cols":7,"rows_kept":38,"cut":false,"hidden":false,"merged":[[22,6,22,8],[23,6,23,8],[19,6,19,8],[20,6,20,8],[21,0,21,2],[21,6,21,8],[22,0,22,2],[23,0,23,2],[27,6,27,8],[32,4,32,8],[30,0,30,3],[32,0,32,3],[30,4,30,8],[29,0,29,2],[35,4,35,8],[36,4,36,8],[37,4,37,8],[34,0,34,3],[35,0,35,3],[36,0,36,3],[37,0,37,3],[34,4,34,8],[9,6,9,8],[10,6,10,8],[0,0,1,8],[4,0,4,1],[4,2,4,3],[4,7,4,8],[3,4,3,5],[4,4,4,5],[5,5,5,6],[5,2,5,3],[7,6,7,8],[8,6,8,8],[16,6,16,8],[18,0,18,2],[11,6,11,8],[14,6,14,8],[17,6,17,8],[14,0,14,2],[15,6,15,8],[18,6,18,8],[13,6,13,8],[13,0,13,2]]}
["RATE INFORMATION - Insured"]
[]
[]
["Funding Type:"]
["Rate Structure:"]
["Effective Date: ",null,{"$f":"IF(ISBLANK('Page 1 '!D3),\"\",'Page 1 '!D3)","v":""},null,"Ending Date:",{"$f":"IF(C6=\"\",\"\",(C6+364))","v":""}]
[]
["RATES",null,null,{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE Only\",IF(E5=\"3 Tier\",\"Emp Only\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE + SP\",IF(E5=\"3 Tier\",\"Emp + 1\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE + Family\",IF(E5=\"3 Tier\",\"Emp + 2 or more\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE + Child(ren)\",IF(E5=\"3 Tier\",\"\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""}]
["Employee Counts"]
["Medical rate"]
["RX Buy Up rate"]
["Vision rate"]
["Wellness Services rate"]
["SUBTOTAL MEDICAL *",null,null,{"$f":"SUM(D10:D13)","v":0},{"$f":"SUM(E10:E13)","v":0},{"$f":"SUM(F10:F13)","v":0},{"$f":"SUM(G10:I13)","v":0}]
["SUBTOTAL VISION",null,null,0,0,0,0]
["Dental Employee Counts"]
["Delta Dental rate"]
["Orthodontia rate"]
["SUBTOTAL DENTAL",null,null,{"$f":"SUM(D17:D18)","v":0},{"$f":"SUM(E17:E18)","v":0},{"$f":"SUM(F17:F18)","v":0},{"$f":"SUM(G17:I18)","v":0}]
["Direct Option Employee Counts"]
["Direct Option Dental rate"]
["SUBTOTAL DIRECT OPTION",null,null,{"$f":"SUM(D21:D21)","v":0},{"$f":"SUM(E21:E21)","v":0},{"$f":"SUM(F21:F21)","v":0},{"$f":"SUM(G21:I21)","v":0}]
["Subtotal",null,null,{"$f":"SUM(D14:D15,D19)","v":0},{"$f":"SUM(E14:E15,E19)","v":0},{"$f":"SUM(F14:F15,F19)","v":0},{"$f":"SUM(G14:G15,G19)","v":0}]
["TOTAL BILLED",null,null,{"$f":"((D9*(D14+D15)+(D16*D19)+(D20*D22)))","v":0},{"$f":"((E9*(E14+E15)+(E16*E19)+(E20*E22)))","v":0},{"$f":"((F9*(F14+F15)+(F16*F19)+(F20*F22)))","v":0},{"$f":"((G9*(G14+G15)+(G16*G19)+(G20*G22)))","v":0}]
[]
["* Non-Standard - Unhide & Use Row 16 if Vision rates need to be broken out from Medical Rates on bill."]
[]
["Rate Guarantee?",null,null,null,"Estimated First Month's Premium:",null,{"$f":"SUM(D24:I24)","v":0}]
[]
["Payment Information:"]
["Premium Payment Method "]
[]
[]
["Commission:"]
["Agent Commission (Medical)"]
["Agent Commission (Dental)"]
["Agent Commission (Pharmacy)"]
["Agent Commission (Vision)"]

{"sheet":"Page 4 - Rates Insured (2)","index":6,"n_rows":39,"n_cols":7,"rows_kept":39,"cut":false,"hidden":true,"merged":[[11,6,11,8],[0,0,1,8],[3,4,3,5],[4,0,4,1],[4,2,4,3],[4,4,4,5],[4,7,4,8],[6,2,6,3],[6,5,6,6],[8,6,8,8],[9,6,9,8],[10,6,10,8],[21,6,21,8],[12,6,12,8],[14,0,14,2],[14,6,14,8],[15,0,15,2],[15,6,15,8],[16,6,16,8],[17,6,17,8],[18,6,18,8],[19,0,19,2],[19,6,19,8],[20,6,20,8],[22,0,22,2],[22,6,22,8],[23,0,23,2],[23,6,23,8],[24,0,24,2],[24,6,24,8],[28,6,28,8],[30,0,30,2],[31,0,31,3],[31,4,31,8],[33,0,33,3],[33,4,33,8],[38,0,38,3],[38,4,38,8],[35,0,35,3],[35,4,35,8],[36,0,36,3],[36,4,36,8],[37,0,37,3],[37,4,37,8]]}
["RATE INFORMATION - Insured"]
[]
[]
["Funding Type:"]
["Rate Structure:"]
[]
["Effective Date: ",null,null,null,"Ending Date:",{"$f":"IF(C7=\"\",\"\",(C7+364))","v":""}]
[]
["RATES",null,null,{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE Only\",IF(E5=\"3 Tier\",\"Emp Only\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE + SP\",IF(E5=\"3 Tier\",\"Emp + 1\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE + Family\",IF(E5=\"3 Tier\",\"Emp + 2 or more\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(E5=\"\",\"\",IF(E5=\"4 Tier\",\"EE + Child(ren)\",IF(E5=\"3 Tier\",\"\",IF(E5=\"Composite\",\"\",IF(E5=\"ASO\",\"\",IF(E5=\"Other-see comments\",\"\"))))))","v":""}]
["Employee Counts"]
["Medical rate"]
["RX Buy Up rate"]
["Vision rate"]
["Wellness Services rate"]
["SUBTOTAL MEDICAL *",null,null,{"$f":"SUM(D11:D14)","v":0},{"$f":"SUM(E11:E14)","v":0},{"$f":"SUM(F11:F14)","v":0},{"$f":"SUM(G11:I14)","v":0}]
["SUBTOTAL VISION",null,null,0,0,0,0]
["Dental Employee Counts"]
["Moda Health/ODS Dental rate"]
["Orthodontia rate"]
["SUBTOTAL DENTAL",null,null,{"$f":"SUM(D18:D19)","v":0},{"$f":"SUM(E18:E19)","v":0},{"$f":"SUM(F18:F19)","v":0},{"$f":"SUM(G18:I19)","v":0}]
["Direct Option Employee Counts"]
["Direct Option Dental rate"]
["SUBTOTAL DIRECT OPTION",null,null,{"$f":"SUM(D22:D22)","v":0},{"$f":"SUM(E22:E22)","v":0},{"$f":"SUM(F22:F22)","v":0},{"$f":"SUM(G22:I22)","v":0}]
["Subtotal",null,null,{"$f":"SUM(D15:D16,D20)","v":0},{"$f":"SUM(E15:E16,E20)","v":0},{"$f":"SUM(F15:F16,F20)","v":0},{"$f":"SUM(G15:G16,G20)","v":0}]
["TOTAL BILLED",null,null,{"$f":"((D10*(D15+D16)+(D17*D20)+(D21*D23)))","v":0},{"$f":"((E10*(E15+E16)+(E17*E20)+(E21*E23)))","v":0},{"$f":"((F10*(F15+F16)+(F17*F20)+(F21*F23)))","v":0},{"$f":"((G10*(G15+G16)+(G17*G20)+(G21*G23)))","v":0}]
[]
["* Non-Standard - Unhide & Use Row 16 if Vision rates need to be broken out from Medical Rates on bill."]
[]
["Rate Guarantee?",null,null,null,"Estimated First Month's Premium:",null,{"$f":"SUM(D25:I25)","v":0}]
[]
["Payment Information:"]
["Premium Payment Method "]
[]
[]
["Commission:"]
["Agent Commission (Medical)"]
["Agent Commission (Dental)"]
["Agent Commission (Pharmacy)"]
["Agent Commission (Vision)"]

{"sheet":"Page 4 -Rates Insured Voluntary","index":7,"n_rows":31,"n_cols":10,"rows_kept":31,"cut":false,"hidden":false,"merged":[[13,6,13,7],[14,6,14,7],[14,8,14,9],[16,0,16,2],[12,0,12,2],[15,6,15,7],[16,6,16,7],[12,6,12,7],[15,0,15,2],[20,8,20,9],[6,5,6,8],[6,2,6,3],[14,0,14,2],[11,8,11,9],[8,8,8,9],[9,8,9,9],[12,8,12,9],[10,8,10,9],[8,6,8,7],[9,6,9,7],[10,6,10,7],[11,6,11,7],[16,8,16,9],[15,8,15,9],[13,8,13,9],[0,0,1,9],[4,0,4,1],[4,2,4,3],[3,4,3,5],[4,4,4,5],[28,4,28,9],[22,0,22,2],[23,4,23,9],[29,4,29,9],[30,4,30,9],[27,0,27,3],[28,0,28,3],[29,0,29,3],[30,0,30,3],[27,4,27,9],[25,4,25,9],[23,0,23,3],[25,0,25,3]]}
["RATE INFORMATION - Insured VOLUNTARY"]
[]
[]
["Funding Type:"]
["Rate Structure:"]
[]
["Effective Date: ",null,{"$f":"IF(ISBLANK('Page 1 '!D3),\"\",'Page 1 '!D3)","v":""},null,"Ending Date:",{"$f":"IF(C7=\"\",\"\",(C7+364))","v":""}]
[]
["RATES",null,null,{"$f":"IF(OR(E5=\"\",E5=\"Composite\",E5=\"ASO\",E5=\"Other-see comments\"),\"\",\"Emp Only\")","v":""},{"$f":"IF(OR(E5=\"\",E5=\"Composite\",E5=\"ASO\",E5=\"Other-see comments\"),\"\",IF(E5=\"3 Tier\",\"Emp + 1\",\"EE + SP\"))","v":""},{"$f":"IF(OR(E5=\"\",E5=\"Composite\",E5=\"ASO\",E5=\"Other-see comments\"),\"\",IF(E5=\"3 Tier\",\"Emp + 2 or more\",\"EE + Family\"))","v":""},{"$f":"IF(OR(E5=\"\",E5=\"3 Tier\",E5=\"Composite\",E5=\"ASO\",E5=\"Other-see comments\"),\"\",IF(E5=\"4 Tier\",\"EE + Child(ren)\",\"EE + Child\"))","v":""},null,{"$f":"IF(OR(E5=\"\",E5=\"3 Tier\",E5=\"Composite\",E5=\"ASO\",E5=\"Other-see comments\",E5=\"4 Tier\"),\"\",\"EE + Children\")","v":""}]
["Employee Counts"]
["Dental rate"]
["Orthodontia rate"]
["SUBTOTAL DENTAL",null,null,{"$f":"SUM(D11:D12)","v":0},{"$f":"SUM(E11:E12)","v":0},{"$f":"SUM(F11:F12)","v":0},{"$f":"SUM(G11:H12)","v":0},null,{"$f":"SUM(I11:J12)","v":0}]
["Direct Option Dental rate"]
["SUBTOTAL MATCH DENTAL",null,null,{"$f":"SUM(D14:D14)","v":0},{"$f":"SUM(E14:E14)","v":0},{"$f":"SUM(F14:F14)","v":0},{"$f":"SUM(G14:H14)","v":0},null,{"$f":"SUM(I14:J14)","v":0}]
["Subtotal",null,null,{"$f":"IF(D15=0,D13,D15)","v":0},{"$f":"IF(E15=0,E13,E15)","v":0},0,0,0,0,0]
["TOTAL BILLED",null,null,{"$f":"D10*D16","v":0},{"$f":"E10*E16","v":0},{"$f":"F10*F16","v":0},{"$f":"+G16*G10","v":0},null,{"$f":"I16*I10","v":0}]
[]
["* Indicate only if Vision rates should be broken out from Medical and Dental Rates on bill."]
[]
["Rate Guarantee?",null,null,null,"Estimated First Month's Premium:",null,null,null,{"$f":"SUM(D17:J17)","v":0}]
[]
["Payment Information:"]
["Premium Payment Method "]
[]
[]
["Commission:"]
["Agent Commission (Medical)"]
["Agent Commission (Dental)"]
["Agent Commission (Pharmacy)"]
["Agent Commission (Vision)"]

{"sheet":"Page 4 - Rates ASO","index":8,"n_rows":76,"n_cols":6,"rows_kept":76,"cut":false,"hidden":false,"merged":[[4,9,4,10],[0,0,1,10],[2,0,2,1],[2,2,2,3],[2,5,2,7],[2,9,2,10],[51,12,51,14],[56,0,56,9],[6,5,6,6],[11,5,11,6],[13,2,13,3],[22,2,22,3],[25,1,25,2],[26,1,26,2],[40,5,40,6],[43,1,43,2],[44,1,44,2],[49,5,49,6],[57,0,57,3],[57,4,57,9],[57,11,57,14],[58,0,58,3],[58,4,58,9],[63,0,63,9],[64,2,64,7],[65,2,65,7],[66,2,66,7],[67,2,67,7],[60,5,60,9],[74,0,74,3],[74,4,74,7],[75,0,75,3],[75,4,75,7],[71,0,71,3],[71,4,71,7],[72,0,72,3],[72,4,72,7],[73,0,73,3],[73,4,73,7],[68,2,68,7],[61,0,61,3],[61,4,61,9],[62,0,62,3],[62,4,62,9]]}
["RATE INFORMATION - ASO"]
[]
["Effective Date: ",null,{"$f":"IF(ISBLANK('[3]Page 1 '!D3),\"\",'[3]Page 1 '!D3)","v":""},{"$f":"IF(ISBLANK(#REF!),\"\",#REF!)","v":{"$error":"#REF!"}},"Ending Date:",{"$f":"IF(C3=\"\",\"\",(C3+364))","v":""}]
[]
["RATES"]
[null,null,null,null,null,"Amount:"]
["Dental",null,null,null,null,"PEPM"]
["Administration:"]
["Commission:"]
["Total:",null,null,null,null,{"$f":"SUM(F8:F9)","v":0}]
[]
["Medical ",null,null,null,null,"PEPM"]
["Administration:"]
["PPO Access Fee"]
["Commission:"]
["E-Doc & Nurseline:"]
["Tobacco Cessation Fee (Alere):"]
["EAP (Employer Assistance Program) Fee:"]
["Injectable Benefits Management Fee (I-CORE):"]
["Subrogation Fee:",null,null,"25% of Savings"]
["Claims Management (CM2) Fee:",null,null,"25% of Savings"]
["OMIP (groups in Oregon with Stop Loss only):"]
["Wellness Services:"]
["Other:"]
[]
[null,"Imaging Management (eviCore) (claim's expense)",null,"$0.55 pmpm","No"]
[null,"Enhanced Musculoskeletal Review (eviCore) (claim's expense)",null,"$1.00 pmpm","No"]
["Total:",null,null,null,null,{"$f":"SUM(F13:F19)+SUM(F22:F24)","v":0}]
[]
["# of Subscribers:"]
["Stop Loss Contract Type:"]
["Specific Stop Loss Fee:",null,null,null,null,{"$f":"+D32","v":0}]
["Specific Level:"]
["Aggregate Stop Loss Fee:",null,null,null,null,{"$f":"+D34","v":0}]
["Aggregate Attachment Point:"]
["Aggregate Level:"]
["Minimum Aggregate Ded (85%):"]
["Stop Loss Interface Fee (for a Stop Loss carrier other than Moda)",null,null,null,null,0]
["Total Stop Loss Fees:",null,null,null,null,{"$f":"F32+F34+F38","v":0}]
[]
["Pharmacy "]
["Administration:",null,"Commercial Group"]
[null,"Moda Administration",null,null,null,"Incl. in Medical"]
[null,"PBM fee (Rx claim's expense)",null,"$0.90 per script"]
[null,{"$f":"IF(C42=\"Consortium Group\",\"Eprescribing-Commercial fee (Rx claim's expense)\",\"\")","v":""},null,{"$f":"IF(C42=\"Consortium Group\",\"$0.20 per Eprescribed transaction\",\"\")","v":""}]
["PBM Interface Fee (for a PBM other than Moda)",null,null,null,null,0]
["Commission:"]
["Total:",null,null,null,null,{"$f":"+F47+F46","v":0}]
[]
["Vision"]
["Administration:",null,null,null,null,"Incl. in Medical"]
["Commission:"]
["Total :",null,null,null,null,{"$f":"SUM(F51:F52)","v":0}]
[]
[]
[]
["ASO Administration - Payment Information "]
["ASO Admin Billing Method:"]
["If list bill, Admin will be paid by:"]
[]
["ASO Claims - Payment Information"]
["ACH Claims Frequency:"]
["ASO Claims Payment Method:"]
["ASO Claims Billing  "]
["Contact Name:"]
["Address:"]
["Phone:"]
["Fax:"]
["Email:"]
[]
["Utilization Report"]
["Will report be sent with the bill or alone?"]
["Report style:"]
["Has PHI Agreement been submitted?"]
["How will group receive bill (mail, fax or email)?"]
["Frequency of Utilization Report:"]

{"sheet":"Page 4 - Rates Minimum Premium","index":9,"n_rows":42,"n_cols":9,"rows_kept":42,"cut":false,"hidden":true,"merged":[[32,7,32,8],[33,7,33,8],[34,7,34,8],[8,7,8,8],[12,7,12,8],[28,7,28,8],[24,7,24,8],[27,7,27,8],[25,7,25,8],[26,7,26,8],[13,7,13,8],[10,7,10,8],[9,7,9,8],[11,7,11,8],[41,0,41,3],[41,4,41,8],[38,0,38,2],[39,0,39,3],[39,4,39,8],[40,0,40,3],[40,4,40,8],[30,0,30,2],[31,0,31,2],[14,7,14,8],[16,7,16,8],[15,7,15,8],[22,0,22,8],[24,0,24,2],[17,7,17,8],[19,7,19,8],[18,7,18,8],[29,7,29,8],[30,7,30,8],[31,7,31,8],[0,0,1,8],[3,0,3,1],[3,2,3,3],[3,7,3,8],[7,7,7,8],[5,7,5,8],[6,7,6,8]]}
["RATE INFORMATION - Minimum Premium"]
[]
[]
["Rate Structure:",null,null,null,"Effective Date:",{"$f":"IF(ISBLANK('Page 1 '!D3),\"\",'Page 1 '!D3)","v":""},"Ending Date:",{"$f":"IF(F4=\"\",\"\",(F4+364))","v":""}]
[]
["RATES",null,null,{"$f":"IF(C4=\"\",\"\",IF(C4=\"4 Tier\",\"EE\",IF(C4=\"3 Tier\",\"Emp Only\",IF(C4=\"Composite\",\"PEPM\",IF(C4=\"ASO\",\"PEPM\",IF(C4=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(C4=\"\",\"\",IF(C4=\"4 Tier\",\"EE + SP\",IF(C4=\"3 Tier\",\"Emp + 1\",IF(C4=\"Composite\",\"\",IF(C4=\"ASO\",\"\",IF(C4=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(C4=\"\",\"\",IF(C4=\"4 Tier\",\"EE + Family\",IF(C4=\"3 Tier\",\"Emp + 2 or more\",IF(C4=\"Composite\",\"\",IF(C4=\"ASO\",\"\",IF(C4=\"Other-see comments\",\"\"))))))","v":""},{"$f":"IF(C4=\"\",\"\",IF(C4=\"4 Tier\",\"EE + Child(ren)\",IF(C4=\"3 Tier\",\"\",IF(C4=\"Composite\",\"\",IF(C4=\"ASO\",\"\",IF(C4=\"Other-see comments\",\"\"))))))","v":""},"Total"]
["Employee Counts",null,null,null,null,null,null,{"$f":"SUM(D7:G7)","v":0}]
["Medical Min. Premium Rate",null,null,null,null,null,null,{"$f":"($D$7*D8)+($E$7*E8)+($F$7*F8)+($G$7*G8)","v":0}]
["Medical MCL Premium Rate",null,null,null,null,null,null,0]
["Rx Min. Premium Rate",null,null,null,null,null,null,0]
["Rx MCL Premium Rate",null,null,null,null,null,null,0]
["Vision Min. Premium Rate",null,null,null,null,null,null,0]
["Vision MCL Premium Rate",null,null,null,null,null,null,0]
["SUBTOTAL MEDICAL",null,null,{"$f":"SUM(D8:D9)","v":0},{"$f":"SUM(E8:E9)","v":0},{"$f":"SUM(F8:F9)","v":0},{"$f":"SUM(G8:G9)","v":0},{"$f":"SUM(H8:I13)","v":0}]
["Dental Min. Premium Rate",null,null,null,null,null,null,{"$f":"($D$7*D15)+($E$7*E15)+($F$7*F15)+($G$7*G15)","v":0}]
["Dental MCL Premium Rate",null,null,null,null,null,null,{"$f":"($D$7*D16)+($E$7*E16)+($F$7*F16)+($G$7*G16)","v":0}]
["Ortho Min. Premium Rate",null,null,null,null,null,null,{"$f":"($D$7*D17)+($E$7*E17)+($F$7*F17)+($G$7*G17)","v":0}]
["Orhto MCL Premium Rate",null,null,null,null,null,null,{"$f":"($D$7*D18)+($E$7*E18)+($F$7*F18)+($G$7*G18)","v":0}]
["SUBTOTAL DENTAL",null,null,{"$f":"SUM(D15:D17)","v":0},{"$f":"SUM(E15:E17)","v":0},{"$f":"SUM(F15:F17)","v":0},{"$f":"SUM(G15:G17)","v":0},{"$f":"SUM(H15:I18)","v":0}]
["TOTAL BILLED",null,null,{"$f":"SUM(D14+D19)","v":0},{"$f":"SUM(E14+E19)","v":0},{"$f":"SUM(F14+F19)","v":0},{"$f":"SUM(G14+G19)","v":0},{"$f":"SUM(H14+H19)","v":0}]
["* Indicate only if Vision rates should be broken out from Medical and Dental Rates on bill."]
[]
[]
["Misc. Information",null,null,null,null,null,null,null,"Included in Minimum Premium rates above?"]
["Specific SL level"]
["Reserves: Medical"]
["Reserves: RX"]
["Reserves: Vision"]
["Reserves: Dental"]
["Reserves: Orthodontia"]
["Agent Commission: Medical"]
["Agent Commission: Rx"]
["Agent Commission: Vision"]
["Agent Commission: Dental"]
["Agent Commission: Orthodontia"]
[]
[]
[]
["Payment Information"]
["Premium Payment Method"]
["ACH  frequency"]
["Positive/Negative billing:"]

{"sheet":"Page 5 - Agent-Signature pg","index":10,"n_rows":45,"n_cols":11,"rows_kept":45,"cut":false,"hidden":false,"merged":[[0,0,0,10],[26,0,26,10],[2,7,2,8],[3,7,3,8],[2,2,2,5],[42,5,42,6],[35,5,35,6],[37,0,37,3],[39,5,39,6],[3,2,3,5],[40,5,40,6]]}
["AGENT INFORMATION"]
[]
["Agent Name",null,"",null,null,null,"Tax ID #",""]
["Agency",null,"",null,null,null,"License #",""]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,"Split Commission Amount:"]
[null,null,null,null,null,null,null,null,null,null,"* For Tax purposes, please indicate if Tax ID or S/S #"]
[]
["I hereby make application to Moda Health/Delta Dental, on behalf of the Group, for the Group Policies"]
["indicated in this group application.  I understand that there is no coverage in effect"]
["until Moda Health/Delta Dental accepts this Application and premium deposit and establishes an "]
["effective date.  If this Application is not accepted, the premium deposit will be refunded."]
[]
["I hereby certify all eligible employees are enrolling in the selected Group Policies "]
["and all enrolling employees meet the eligibility requirements specified above.  "]
["In addition, I hereby appoint the above agent as our Agent of Record to"]
["represent us in matters of group insurance benefits provided by Moda Health/Delta Dental.  This"]
["appointment is in effect on the same day as this Policy and will remain in force until"]
["rescinded in writing."]
[]
["For all medical plans only:"]
["In addition, I hereby acknowledge responsibility on behalf of the Group to provide the "]
["Summary of Benefits & Coverage (SBC), Uniform Glossary, and the Initial Notice of HIPAA"]
["Special Enrollment Rights and Exclusion Periods to all employees on or before the date"]
["they enroll in the selected Group Policies."]
[]
["By signing below, I agree that the signature will be the electronic representation of my signature"]
["and initials for all purposes when I (or my agent) uses them on documents, including legally binding contracts."]
[]
[]
["X"]
["Authorized Signature for GROUP",null,null,null,null,null,null,"Authorized Signer's Title"]
[]
["Authorized Signer's Printed Name",null,null,null,null,null,null,null,"Date"]
[]
["X"]
["Authorized AGENT Signature"]
[]
["Authorized Agent's Printed Name",null,null,null,null,null,null,null,"Date"]
[]
["X"]
["Marketing Representative Signature",null,null,null,null,null,null,null,"Date"]

{"sheet":"Page 7 - ESA Agreement ","index":11,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"Nondiscrimination_Taglines","index":12,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"Page 8 - Acct Structure","index":13,"n_rows":48,"n_cols":7,"rows_kept":48,"cut":false,"hidden":false,"merged":[[47,1,47,8],[48,1,48,8],[12,2,12,6],[14,2,14,8],[18,5,18,7],[19,5,19,7],[30,7,30,8],[32,7,32,8],[33,2,33,8],[45,5,45,7],[41,5,41,7],[43,5,43,7],[34,7,34,8],[35,2,35,8],[36,7,36,8],[44,5,44,7],[38,2,38,8],[4,3,4,4],[5,6,5,8],[5,3,5,4],[6,6,6,8],[7,2,7,4],[7,6,7,8],[28,7,28,8],[29,2,29,8],[10,2,10,8],[15,1,15,8],[6,2,6,4],[0,1,0,8],[9,1,9,8],[40,5,40,7],[16,1,16,8],[42,5,42,7],[2,1,2,8],[31,2,31,8],[20,5,20,7],[21,5,21,7],[22,5,22,7],[23,5,23,7],[27,1,27,8],[11,7,11,8],[13,7,13,8],[3,6,3,8],[3,2,3,4]]}
[null,"Account Structure Worksheet"]
[null,null,"Cobra"]
[null,"Moda Health subsidiary, BenefitHelp Solutions (BHS), provides COBRA Administration at no additional cost to Moda Health Medical Groups or Moda Health Medical Groups with Delta Dental of Oregon.  If your group is sized 51-99, BHS Cobra Administration is included in the Moda Health and Delta Dental products only. Fees will apply to groups with 100+ eligible and for groups who choose BHS administration for product lines outside of Moda Health.  If electing to use BHS to administer your COBRA, mark Yes for question 9b."]
[null,"1.","Does the group use a TPA for COBRA or Retiree Administration? ",null,null," (Y/N):"]
[null,"1a.","If yes, enter TPA name and address:"]
[null,null,"Phone:",null,null,"Contact:"]
[null,"1b.","If no, will the group elect COBRA administration through BenefitHelp Solutions (BHS)?                                                                                                                                                                                            ",null,null," (Y/N):"]
[null,"1c.","Who will be paying the COBRA premiums?"]
[]
[null,"     Billing "]
[null,"2.","Are billing statements sent to multiple locations? If yes, please list each location and their billing address below."]
[null,null,null,null,null,null," (Y/N):"]
[null,"3.","Will the group need the members separated on the invoice?"]
[null,null,null,null,null,null," (Y/N):"]
[null,null,"If yes, please be sure to indicate the subgroup that each member belongs to on their enrollment form.  Please list these subgroups below."]
[null,"If you answered yes to any of the above questions, please list each location/subgroup and their billing address:"]
[]
[null,null,"Define Subgroups:",null,"Subgroup Address:"]
[null,"I.",null,null,"Address 1"]
[]
[null,"II.",null,null,"Address 2"]
[]
[null,"III.",null,null,"Address 3"]
[]
[]
[]
[null,null,"Class Structure"]
[null,"4.   Does the billing statement need to be sorted by classification?"]
[null,null,null,null,null,null," (Y/N):"]
[null,"5.","Do all employees have the same benefit options?"]
[null,null,null,null,null,null," (Y/N):"]
[null,"6.","Are there specific reporting requirements for each classification of employee?"]
[null,null,null,null,null,null," (Y/N):"]
[null,"7. ","Is the eligibility waiting period the same for each classification?"]
[null,null,null,null,null,null," (Y/N):"]
[null,"8. ","Does each class use the network listed on page 3?"]
[null,null,null,null,null,null," (Y/N):"]
[]
[null,"9.","If you answered yes to any of the above questions, please define the classes and benefits below."]
[null,null,"Define Classifications:",null,"Define Benefits:"]
[null,"I.",null,null,"Benefit 1"]
[null,"II.",null,null,"Benefit 2"]
[null,"III.",null,null,"Benefit 3"]
[null,"IV.",null,null,"Benefit 4"]
[null,"V.",null,null,"Benefit 5"]
[null,"VI.",null,null,"Benefit 6"]
[]
[null,"Comments:"]

{"sheet":"RX_ELIGIBILITY_LG_DROPDOWN (2)","index":14,"n_rows":18,"n_cols":5,"rows_kept":18,"cut":false,"hidden":true,"merged":[]}
[]
["Discount Card",null,null,null,"Date of Hire"]
["Modified",null,null,null,"Date of Hire plus one month orientation period"]
["RX01525502XC90",null,null,null,"DOH or DOH when 1st of the month"]
["RX01535502XC90",null,null,null,"DOH or DOH when 1st of the month plus one month orientation period"]
["RX1020%502XC90",null,null,null,"30 days"]
["RX1020502XC90",null,null,null,"30 days plus one month orientation period"]
["RX1025502XC90",null,null,null,"60 days"]
["RX1525$502XC90",null,null,null,"60 days plus one month orientation period"]
["RX1525502XC90",null,null,null,"90 days (dental only)"]
["RX15502XC90",null,null,null,"90 days plus one month orientation period (dental only)"]
["RX250D15DW25502XC90"]
["RX25CA90"]
["RX30CA90"]
["RX35CA90"]
["RX515502XC90"]
["RX60C90"]
["RX70C90"]

{"sheet":"Checklist","index":15,"n_rows":33,"n_cols":9,"rows_kept":33,"cut":false,"hidden":true,"merged":[[25,6,25,7],[21,6,21,7],[21,4,21,5],[20,0,20,3],[20,4,20,5],[20,6,20,7],[21,0,21,2],[22,6,22,7],[25,0,25,3],[25,4,25,5],[3,4,3,5],[4,0,4,3],[22,0,22,3],[20,8,20,9],[11,0,12,9],[7,0,9,9],[21,8,21,9],[4,4,4,5],[22,4,22,5],[22,8,22,9],[25,8,25,9],[24,0,24,3],[0,0,0,10],[18,0,18,10],[2,4,2,5],[2,8,2,9],[3,0,3,3],[5,0,5,3],[5,8,5,9],[5,4,5,5],[2,6,2,7],[3,6,3,7],[3,8,3,9],[4,8,4,9],[4,6,4,7],[5,6,5,7],[27,4,27,5],[30,0,30,9],[26,0,26,3],[27,0,27,3],[28,8,28,9],[27,8,27,9],[26,6,26,7],[27,6,27,7],[28,6,28,7],[26,4,26,5],[26,8,26,9],[32,0,32,2],[31,4,31,9],[28,0,28,3],[33,4,33,9],[32,4,32,9],[28,4,28,5]]}
["NEW & RENEWALS"]
["THE GROUP PLAN IS BEST DEFINED AS "]
[null,null,null,null,"Medical",null,"Pharmacy",null,"Dental"]
["ODS STANDARD PLAN - Group accepts contract comparison changes effective under plans pertaining to Medical (all 4-digit plans (2-50) and all 11- digit plans (51+)) and Dental (all plans)."]
["NON-STANDARD PLAN - Group does not accept all contract comparison changes effective under standard plans.  Intended benefits fall within the variables filed with the state and group is defined as a non-standard ODS plan.  If unknown, verify plan type with Contract Department."]
["NEGOTIATED PLAN - Group does not accept all contract comparison changes effective under standard plans.  Benefit design is unique to ODS and group plan is defined as a negotiated plan.  If unknown, verify plan type with Contract Department."]
[]
["PLEASE NOTE: Management approval is required for: 1) New groups with less than 100 employees/primary subscribers enrolled requesting a non-standard or negotiated plan, 2) Existing groups with less than 100 employees/primary subscribers enrolled switching."]
[]
[]
[]
["Management approval is not required for existing groups currently on a non-standard or negotiated plan to continue on a non-standard or negotiated plan."]
[]
[]
["Marketing Management Approval ",null,null,"Date"]
[null,null,null,null,null,null," "]
["Underwriting Management Approval ",null,null,"Date"]
[]
["RENEWALS ONLY"]
[]
["#1 Please Check One:",null,null,null,"Medical",null,"Pharmacy",null,"Dental"]
["Group is renewing with current Plan design."]
["Group is renewing with Plan design changes."]
[]
["#2 Please Check One:"]
["Group has accepted all changes indicated on plan comparison (do not include copy of contract comparison with the group app)."]
["**Group has not accepted changes on the plan comparison (include copy of contract comparison with the group app)."]
["Plan comparison is still being reviewed by the group/agent.  Upon receipt of approval, Marketing will forward a copy to the Contracts Department and the Benefits Programming Department."]
["The contract comparison is currently being drafted by the Contract Department and has NOT been sent to the group or agent.  Upon receipt of approval, Marketing will forward a copy to both the Contracts Department and the Benefits Programming Department."]
[]
["**If all benefits are not accepted, a contract comparison, whether it is signed by the group or not, must be included with all renewal group applications in order to begin programming and drafting contracts/member handbooks."]
[null,null,null,"Medical","Dental"]
["Indicate the Group Plan Changes version that was sent to the group            "]

{"sheet":"Pg 13-Consortium Fees(Internal)","index":16,"n_rows":3,"n_cols":1,"rows_kept":3,"cut":false,"hidden":true,"merged":[[60,0,60,1],[61,1,61,2],[2,0,2,1],[21,0,21,1],[45,0,45,1],[48,0,49,0],[48,1,49,1]]}
["Consortium Contractual Fees"]
[]
["To receive a copy of the Consortium Contractual Fees listing and further direction on billing requirements please contact the Pharmacy Account Services team. "]